Evaluation of Relevance in Concussion and Damage of Health by Monitoring of
Neuron Specific Enolase and S-100b Protein
Vajtr D.1,2, Průša R.2, Kukačka J.2, Houšťava L.3, Šámal F.3, Pelichovská M.4, Strejc P.1, Toupalík P.5
1Ústav soudního lékařství a toxikologie UK 1. LF a VFN, Praha 2Ústav klinické biochemie a patobiochemie UK 2. LF a FN Motol, Praha 3Klinika neurochirurgie UK 3. LF a FN Královské Vinohrady, Praha 4Klinika anesteziologie a resuscitace UK 2. LF a FN Motol, Praha5Ústav soudního lékařství 2. LF UK, Praha |
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Summary:
Introduction: Proteins released to the circulation from affected glial (neuron specific enolasis,
NSE) or ganglial cells (S-100b protein) during traumatic brain injury might be used in diagnosis of
traumatic brain injury in cases with negative finding on computer tomography scan (concussion)
or in patients where the serious clinical status does not corresponde with mild changes on CT scan
(diffuse axonal injury, DAI). Classification of DAI according Gennarelli considered the concussion
as lower degree of DAI. Materials and method: 15 patients were divided into group I of mild
conccussion (n=3) with 1-day duration of hospitalisation, group II of serious concussion (n=4) with
more days duration of hospitalisation with negative findings on CT scan and group III of patients
with diagnosis of DAI (n=8). Blood samples were investigated by immunoanalysis for NSE and
protein S-100b (Elecsys 2010, Roche). Results: Values of NSE (16.30 ± 2.33 vs. 110.48 ± 34.99 vs. 24.07
± 6.29 μg/l), and protein S-100b (0.207 ± 0.03 vs. 0.945 ± 0.69 vs. 0.736 ± 0.36 μg/l) overdrow the
reference value in cases of group I, II, and III.We discuss the biomechanics of trauma and the blood
brain barrier damage in comparison with values of NSE and S-100b protein. Conclussion: We
proved the significantly higher values of the NSE in group of serious concussion compared to
group of DAI. We demonstrated that concussions in some cases lead to serious damage of health.
Key words:
concussion – diffuse axonal injury - neuron specific enolasis – S-100b protein – damage
of health
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