Clinical study
Management of minor head injury: the value of early computed tomography and serum protein S-100 measurements

https://doi.org/10.1016/S0967-5868(97)90007-2Get rights and content

Abstract

Computed tomography (CT) scan was performed within 6 h in 91 patients with minor head injury (MHI). Eight patients (9%) demonstrated intracranial lesions on CT scan (6 brain contusions, 1 brain edema and 1 extradural hematoma). No patient required craniotomy. In patients with normal CT scan, no complications to the head injury were observed. Patients with intracranial lesions were hospitalized significantly longer (mean 9.4 days) than patients without (mean 1.6 days). In a subgroup of 50 patients with normal CT scan, serum S-100 protein was measured on admission. Elevated S-100 levels were seen in 10 of 50 patients (0.5–2.4 μg/L, mean 1.1). These patients were hospitalized significantly longer (mean 3.4 days) compared to patients with normal CT scan and normal S-100 levels (mean 1.1 days). MHI patients with GCS 14–15 without neurological deficits can safely be discharged when CT scan is normal. Serum protein S-100 measurements appear to provide information about diffuse brain injury after MHI.

References (34)

  • JT Povlishock et al.

    Axonal change in minor head injury

    J Neuropath Exp Neurol

    (1983)
  • L Rabow et al.

    Creatine kinase BB activity after head trauma related to outcome

    Acta Neurochir (Wien)

    (1985)
  • IM Skogseid et al.

    Increased serum creatine kinase BB and neuron-specific enolase following head injury indicates brain damage

    Acta Neurochir

    (1992)
  • T Ingebrigtsen et al.

    Increased serum levels of protein S-100 after minor head injury: a biochemical serum marker with prognostic value?

    J Neurol Neurosurg Psychiatry

    (1995)
  • R Jensen et al.

    Characterization of human brain S-100 protein fraction: amino acid sequence of S100β

    J Neurochem

    (1985)
  • OC Fagnart et al.

    Particle counting immunoassay of S-100 protein in serum

  • SR Shackford et al.

    The clinical utility of computed tomographic scanning and neurologic examination in the management of patients with minor head injuries

    J Trauma

    (1992)
  • Cited by (59)

    • Minor traumatic brain injury in sports: a review in order to prevent neurological sequelae

      2007, Progress in Brain Research
      Citation Excerpt :

      Later studies, however, demonstrated its presence in the body in different forms, and that the β form predominates in the brain (Moore, 1965; Ingebrigsten et al., 1995, 1997, 1999, 2000; Woertgen et al., 1997; Ingebrigsten, 1998; McKeating et al., 1998; Raabe et al., 1998; Hermann et al., 1999, 2001; Romner et al., 2000; Biberthaler et al., 2001; Pleines et al., 2001). Increased serum S-100β protein concentrations in peripheral blood are considered as a marker for dysfunction of the blood-brain barrier and therefore, protein S-100β release into peripheral blood may indicate functional brain dysfunction without the necessary presence of a pathology visible through use of CT imaging (Moore, 1965; Ingebrigsten et al., 1995, 1997, 1999, 2000; Woertgen et al., 1997; Ingebrigsten, 1998; McKeating et al., 1998; Raabe et al., 1998; Hermann et al., 1999, 2001; Romner et al., 2000; Biberthaler et al., 2001; Pleines et al., 2001). Little is known regarding the mechanism by which S-100β passes through the blood-brain barrier and enters the blood.

    View all citing articles on Scopus
    View full text