Related Experiment Video

Updated: Sep 25, 2026

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
06:18

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury

Published on: March 26, 2019

Cerebrospinal fluid procalcitonin and severe traumatic brain injury in children

Yong Y Han1, Joseph A Carcillo, Randall A Ruppel

  • 1Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, PA, USA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 10, 2003
PubMed

Insights

Cerebrospinal fluid procalcitonin is elevated in children with severe traumatic brain injury. Abusive head trauma may attenuate this response, suggesting potential neuroprotection or delayed care. Further research is needed.

Area of Science:

  • Pediatric critical care medicine
  • Neuroscience
  • Biomarker research

Background:

  • Severe traumatic brain injury (TBI) in children presents significant management challenges.
  • Cerebrospinal fluid (CSF) procalcitonin is a potential biomarker for inflammation and infection.
  • Understanding biomarkers in pediatric TBI is crucial for diagnosis and prognosis.

Purpose of the Study:

  • To investigate the relationship between CSF procalcitonin levels and severe TBI in pediatric patients.
  • To compare CSF procalcitonin concentrations between children with severe TBI and control groups.
  • To explore factors influencing CSF procalcitonin levels in pediatric TBI, including mechanism of injury.

Main Methods:

  • A prospective, observational study was conducted in a tertiary-care pediatric intensive care unit.
  • CSF procalcitonin concentrations were measured using an immunoluminometric assay.
  • Patients with severe TBI (Glasgow Coma Scale score <8) requiring external ventricular drainage were compared to controls.

Main Results:

  • CSF procalcitonin levels were significantly higher in children with severe TBI compared to controls (0.41 ng/mL vs. 0.12 ng/mL, p <.001).
  • Elevated CSF procalcitonin was also observed in abusive head trauma cases, though less pronounced than in accidental TBI.
  • Time after injury and abusive head trauma mechanism were associated with a reduced CSF procalcitonin response.

Conclusions:

  • CSF procalcitonin concentration is elevated following severe TBI in children.
  • The attenuated procalcitonin response in abusive head trauma warrants further investigation.
  • Future studies are needed to clarify the physiological role and clinical significance of procalcitonin in pediatric TBI.
Abstract

Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Synthesis and Functions of Calcitonin00:51

Synthesis and Functions of Calcitonin

Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...