The Effect of S-100B Protein and Risk Factors on Indication of Cranial Computed Tomography in Patients with Minor Head Injury

PURPOSE: S-100B protein is a reliable biomarker of brain injury. The clinical decision rules for screening of a cranial computed tomography (CCT) in minor head injury patients remain controversial. The purpose of this study was to determine whether S-100B protein and risk factors for minor head injury patients can provide meaningful insights to improve initial CCT scanning of patients with MHI. METHODS: Fifty patients with MHI were enrolled in this prospective study from July 2007 to September 2007. All patients who fulfilled the following inclusion criteria were enrolled: history of head trauma, initial GCS score of 14 to 15, and one or more clinical findings. Risk factors of patients presented in this study included age younger than 2 years or above sixty years, focal neurologic deficit (FND), post-traumatic seizure, skull fracture, extra-cranial injury, coagulopathy, previous neurologic deficit and ingestion of toxicants (drugs or alcohol). A venous blood sample for assessment of S-100B protein was drawn and a CCT scan was undergone. The reference value of S-100B protein was 0.105 microgram/L. All CCT findings were confirmed by radiologists. RESULTS: Of the 50 patients studied, 15 patients exhibited trauma-relevant intracranial lesions on the CCT scan (CCTpositive). The subgroups of CCT-positive and -negative showed no statistically difference in S-100B level (p=0.068). Of the fifty patients, thirteen had no risk factors (RF). However, statistically significant differences were observed in S-100B level when the subgroups were classified into RF-positive and RF-negative groups (p=0.016). The CCTpositive findings of 13 patients with no RF were identified with 100% sensitivity, 54.6% specificity, 28.6% positive predictive value and 100% negative predictive value through assessment of S-100B protein level. CONCLUSION: In patients with MHI, S-100B protein level and risk factors may give us reliable predictive information prior to CCT screening in emergency department.

Factores de riesgo asociados a neurocisticercosis en un hospital público de México / Risk factors associated with neurocysticercosis in a public hospital in Mexico

Objetivo: Determinar los factores de riesgo asociados con neurocisticercosis en un hospital público de México. Material y métodos: Se analizaron factores socioeconómicos, demográficos, patrones higiénicos, dietéticos y antecedentes familiares asociados en 85 casos y 170 controles. La muestra se tomó de pacientes que acudieron al estudio de tomografía de cráneo. Los casos presentaron calcificaciones en cráneo compatibles con neurocisticercosis y de acuerdo con la densitometría (Unidades Hounsfield) se definió el tejido normal, las calcificaciones fisiológicas, patológicas así como otras lesiones. Los controles compartían la misma demanda de atención, sin presentar el evento en estudio. Para el análisis estadístico se utilizaron los paquetes computacionales SPSS v 11® y Epi-Info 2002®. Resultados: Las principales manifestaciones clínicas fueron las crisis convulsivas RM 4.2 (IC95% 2.40-9.67); se consideraron factores de riesgo: ingerir alimentos en vía pública RM 2.33 (IC95% 1.25-4.38) y tener antecedentes familiares de neurocisticercosis RM2.37 (IC95% 1.11-5.04), predominó en la población urbana, en la región centro norte de la República Mexicana.

OBJECTIVE: A case-control study was carried out to determine risk factors associated with neurocysticercosis in a public hospital in Mexico. METHODS: The following factors were analyzed: Socioeconomic, sociodemographic, hygiene, eating habits, and family history of neurocysticercosis in 85 cases and 170 controls. Cases were patients with cranial computed tomography images compatible with neurocysticercosis. The densitometric analysis (Hounsfield units) allowed us to distinguish normal tissue from physiological and pathological calcifications, and other types of lesions. Controls were admitted for neurocysticercosis but findings were not compatible with initial diagnosis. Statistical analysis was done using SPSS and Epi-info 2002. RESULTS: The most common clinical manifestation in patients was epileptic seizures OR=4.2 (IC 95% 2.40-9.67). With regards to risk factors, consumption of street food OR=2.33 (IC 95% 1.25-4.38), and family history of neurocysticercosis OR= 2.37 (IC 95% 1.11-5.04) were found to be associated with neurocysticercosis. In the north central region of Mexico where this study was performed, the disease was more frequent among urban populations.

Association of serum protein S100b in intracerebral hemorrhage patients with nerve function lesion / 第三军医大学学报

Objective To investigate the relationship between serum protein S100b in intracerebral hemorrhage (ICH) patients and brain damage. Methods A total of 37 hypertensive cerebral hemorrhage patients, 24 male and 13 female, were enrolled as intracerebral hemorrhage (ICH) group, aged from 45 to 85 years with an average of (69.2?8.9) years. The control group were matched with ICH group, including 30 healthy subjects, 19 male and 11 female, aged 52 to 70 (61.2?5.0) years. The concentration of serum protein S100 was detected using double antibody sandwich ELISA. Evaluation of blood volume was calculated with the fomula based on cranial CT data: V=S?L?Slice??/6. The nerve function of the patients was evaluated by the CSS during acute phase and Barthel index score at 3 month after stroke. Results Serum protein S100 concentration was significantly elevated in patients with ICH (0.54?0.41 ?g/L), as compared to controls (0.17?0.04 ?g/L)(P

An Acoustic Neurinoma with Intratumoral Hemorrhage

Acoustic neurinoma are the most frequent tumors in the region of the cerebellopontine angle. They usually present with a gradual onset of symptoms and slow progression. Development of spontaneous hemorrhage with sudden aggravation of symptoms is rare. The authors present a case of acoustic neurinoma associated with a spontaneous intratumoral hemorrhage. Sudden aggravation of symptoms was noticed. The cranial computed tomography revealed multiple blood-fluid levels within the cysts of the tumor which was located in the region of the right cerebellopontine angle. Operation was performed, which confirmed recent hemorrhage within the tumor. Pathological study revealed a typical neurilemmoma associated with hemorrhage, vascular proliferation and macrophages which phagocytosed hemosiderin pigments. The rare sudden aggravation of symptoms in cases of acoustic neurinoma may suggest hemorrhage.