Immune system status in the patients after severe brain injury

Extracranial complications occuring after severe brain injury definitely aggravate clinical status and debase Glasgow Outcome Score (GOS). The immune system disorders could cause for example pneumonia and other inflammatory complications - urinary infection, coagulopathy, etc.

We have admitted and observed a group of 8 patients with various degree of brain injury and we have demonstrated some changes of immune system parametres after the insult.

Most of the patients had a significant loss in cell mediated immunity parametres, especially T-lymphocytes (CD3+, helper cells) levels were decreased, whereas B-lymphocytes levels were increased. Humoral parametres and acute phase proteins levels were also changed. C-reatcive protein level increased in all cases. However the levels of C3 and C4 were lower. The level of IgE antibodies were high and they even got higher. They achieved the values typical for atopic reaction or parasitic diseases.

Patients with immune system disorders have more extracranial complications. Patients with lower Glasgow Coma Scale after admission have often immune system disorders. However the prognostic value of monitoring of immue system disorders seems to be low. (Tab. 2, Fig. 3, Ref: 9.)