Serum S-100B Protein as a Prognostic Factor in Patients with Severe Head Injury

ABSTRACT

OBJECTIVE: Despite the recent progress that has been made in intracerebral monitoring, it is still difficult to quantify the exact extent of primary brain damage after severe head injury. In this work, we investigate the role of S-100B protein as a serum marker of brain damage after severe head injury. METHODS: 21 patients with severe head injury (GCS score <9) were selected for this prospective study. A venous blood sample was taken as soon as possible after head injury and the serum concentration of S-100B protein was measured daily for five consecutive days. The serum level of S-100B protein was compared with the patients' outcome. The outcome was measured twice, at hospital discharge and after 6 months of follow-up using the Glasgow Outcome Scale(GOS). RESULTS: Those patients who died within two weeks (after head injury) had a significantly higher serum S-100B value than those who survived (median, 9.64 ug/L versus 2.91 ug/L). Seven (78%) of the nine patients who died had a maximum S-100B value of 2 ug/L or higher, while three (25%) of the twelve surviving patients showed a maximum S-100B protein value of more than 2 ug/L (P<0.05). CONCLUSION: These results indicate that S-100B protein appears to be the most reliable index for estimating the extent of brain damage.