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Updated: Jun 19, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Diagnostic value of S100B and neuron-specific enolase in mild pediatric traumatic brain injury
Christian Geyer1, Anett Ulrich, Gerd Gräfe
1Department of Pediatric Surgery, University of Leipzig, Germany. christian.geyer@medizin.uni-leipzig.de
Insights
S100B and NSE serum levels do not reliably distinguish between symptomatic and asymptomatic children after minor head trauma. These biomarkers may have limited sensitivity for diagnosing mild traumatic brain injury (TBI) in pediatric patients.
Area of Science:
- Pediatric Traumatology
- Clinical Biomarker Research
- Neuroscience
Background:
- Traumatic brain injury (TBI) diagnosis in children relies on clinical assessment.
- Biomarkers like S100B and NSE are explored for TBI diagnosis.
- Accurate differentiation between symptomatic and asymptomatic minor head trauma is crucial.
Purpose of the Study:
- To evaluate the efficacy of S100B and NSE serum concentrations in differentiating symptomatic from asymptomatic children with minor head trauma.
- To assess the correlation of these biomarkers with clinical factors in pediatric head injury.
Main Methods:
- Prospective study of 148 children (6 months to 15 years) with minor head trauma.
- Serum S100B and NSE levels measured within 6 hours post-injury.
- Comparison between mild TBI group (GCS 13-15 with symptoms) and head contusion group (GCS 15, asymptomatic).
Main Results:
- No significant difference in S100B or NSE levels between symptomatic and asymptomatic groups after adjusting for age and time to blood draw.
- Scalp lacerations and GCS scores did not impact S100B/NSE concentrations.
- Significant positive correlation between S100B and NSE; significant negative correlation with age.
Conclusions:
- S100B and NSE serum concentrations are not effective discriminators for symptomatic versus asymptomatic pediatric minor head injury.
- Current biomarker sensitivity may be insufficient for diagnosing mild TBI in children.
- Further research is needed to identify reliable biomarkers for pediatric mild TBI.
Object:
During recent years, several biomarkers have been introduced for use in the diagnosis of traumatic brain injury (TBI). The primary objective of this investigation was to determine if S100B (or S100 calcium-binding protein B) and neuron-specific enolase (NSE) serum concentrations can effectively be used to discriminate between symptomatic and asymptomatic children with minor head trauma.
Methods:
The authors conducted a prospective clinical study that involved patients age 6 months to 15 years who had sustained minor head trauma. Children with concomitant extracranial injuries were excluded. Blood samples were obtained within 6 hours of injury to measure S100B and NSE levels in serum. The authors defined 2 diagnostic groups: a mild TBI group (patients with Glasgow Coma Scale [GCS] scores of 13-15) in whom there were clinical signs of concussion (short loss of consciousness, amnesia, nausea, vomiting, somnolence, headache, dizziness, or impaired vision) and a head contusion group (patients with a GCS score of 15) in whom symptoms were absent. Both S100B and NSE concentrations were compared between the 2 groups. Secondary end points were defined as follows: correlation of S100B/NSE and a) the presence of scalp lacerations, b) GCS score, c) age, and d) correlation between S100B and NSE.
Results:
One hundred forty-eight patients were enrolled (53 in the contusion group, 95 in the mild TBI group). After adjusting for differences in age and time of injury to blood sample withdrawal, there was no significant difference in S100B or NSE between patients in the 2 groups. Scalp lacerations and GCS score had no affect on posttraumatic S100B or NSE concentrations. The correlation between S100B and NSE was significant. Both markers showed a significant negative correlation with age.
Conclusions:
The authors demonstrated that S100B and NSE do not discriminate between symptomatic and asymptomatic children with minor head injury. There seem to be limitations in marker sensitivity when investigating pediatric patients with mild TBI.
