Evaluation of head injured patients: comparison of clinical, CT scanning and neurobiochemical markers as predictors of outcome

To investigate the predictive value of the initial serum level of NSE and S-100B compared with the GCS score and cranial CT scan in the prediction of outcome in cases of head injury. Thirty patients with different grades of traumatic head injury were enrolled in this study after taking an informed consent. Data obtained on admission included age, sex and GCS. In addition, cranial CT was done and serum samples were taken from each patient for determination of NSE and S-100B levels. GOS was obtained at the time of patients' discharge. The mean age of head injured patients was 26.70 +/- 10.96 years. Males constituted 66.7% of the cases. It was found that initial GCS score was significantly correlated with GOS with a sensitivity of 85.71%, a specificity of 95.65% and overall accuracy of 93.33%. A significant correlation was also found between CT findings and GOS and the predictive value of CT findings was found to be of 100% sensitivity, specificity and overall accuracy. Post-traumatic serum concentrations of S-100B and NSE were found to be significantly higher in patients with poor outcome compared to those with good outcome, and a significant negative correlation was found between these levels and the GOS. The overall accuracy for the S-100B and NSE were 90.0% and 96.67%, respectively. Clinical interpretation of outcome in traumatic head injury is not a reliable method. CT scanning and neurobiochemical markers, especially NSE, are better predictors

Effects of neuropeptide derivative FPF 1070 [cerebrolysin] administration on experimental acute spinal cord injury: a histological study

Cerebrolysin is a neuropeptide-derived synthetic preparation produced by enzymatic breakdown of lipid-free animal neuroproteins. It regulates the neuronal energy metabolism and is supposed to afford brain protection by its neurotrophic stimulation. The present study aimed at assessing the possible neuroprotective effects of Cerebrolysin on an experimentally induced spinal cord injury in dogs depending on clinical and histological bases. The experiment was conducted on 20 adult male dogs, which were divided among five groups: A sham operated control group [subjected only to laminectomy of the midthoracic vertebrae], a positive control group [subjected to laminectomy with subsequent daily Cerebrolysin administration for 15 days], an acute spinal cord injury group [injury was induced by compression using an inflated balloon of the Folleyis catheter over the mid-thoracic spinal cord segments] and the animals were killed 24 hours after the surgery, a spinal cord injury group with subsequent daily administration of isotonic saline for 15 days and a spinal cord injury group with subsequent daily Cerebrolysin administration for 15 days. Clinical follow up of the experimental animals was daily recorded for 30 days, after which serial sections were prepared from the injured spinal cord segments of the different sacrificed groups. They were examined histologically by routine haematoxylin and eosin and by toluidine blue stains. The end results proved that Cerebrolysin achieved satisfactory protection to the nervous tissue. It prevented the setting in of degenerative changes in the majority of the anterior horn neurons of the injured spinal cord segments and subsequently its propagation in the axonal nerve fibers in the white matter. Therefore, Cerebrolysin administration was recommended as a successful treatment during the management of acute spinal cord injuries. It was also suggested that studies should be extended to investigate a possible similar effect in the case of human spinal cord injury as well as in chronic lesions