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Neuroprotein s-100B -- a useful parameter in paediatric patients with mild traumatic brain injury?
C Castellani1, P Bimbashi, E Ruttenstock
1Department of Pediatric Surgery, Medical University Graz, Graz, Austria. christoph.castellani@meduni-graz.at
Insights
Serum S-100B levels can help rule out intracranial injuries in children with mild traumatic brain injury (MTBI). While elevated S-100B doesn't always indicate a CT scan abnormality, levels below the threshold safely exclude significant lesions.
Area of Science:
- Pediatric neurology
- Biomarkers in traumatic brain injury
- Neurotraumatology
Background:
- Mild traumatic brain injury (MTBI) is common in children.
- Cranial computerized tomography (CCT) scans are often used to assess injury severity.
- Identifying reliable biomarkers for MTBI assessment is crucial.
Purpose of the Study:
- To investigate the correlation between serum S-100B levels and CCT findings in pediatric patients following MTBI.
- To evaluate the diagnostic performance of S-100B in identifying pathological CCT results.
Main Methods:
- A prospective study included 109 pediatric patients (0-18 years) with MTBI.
- Serum S-100B levels were measured within 6 hours of trauma, with a reference upper limit of 0.16 mug/L.
- All patients underwent CCT scans, and results were correlated with S-100B values.
Main Results:
- CCT scans revealed abnormalities (intracerebral hemorrhages/skull fractures) in 36 patients.
- Serum S-100B levels were significantly higher in patients with abnormal CCT findings (p = 0.003).
- The study reported a sensitivity of 1.00 and a specificity of 0.42 for S-100B, with 42 false positives and no false negatives.
Conclusions:
- Serum S-100B is a valuable tool for ruling out pathological CCT findings in pediatric MTBI cases.
- Low S-100B values effectively exclude intracranial lesions.
- Elevated S-100B levels do not always correlate with positive CCT findings, indicating a need for careful interpretation.
Aims:
To examine the correlation of S-100B to cranial computerized tomography (CCT) scan results in children after mild traumatic brain injury (MTBI).
Methods:
One hundred and nine paediatric patients (0-18 years) with MTBI were included in this prospective single-centre study. Serum was collected within 6 h of trauma for determination of serum S-100B. The upper reference of S-100B was set to 0.16 mug/L. A CCT scan was performed in all patients and the results were correlated to the S-100B values.
Results:
Computerized tomography was abnormal in 36 patients showing intracerebral haemorrhages and/or skull fractures. Serum S-100B level was significantly higher in patients with a pathological condition as shown in CT scan results (p = 0.003). There were no false negative, but 42 false positive test results for S-100B. This resulted in a sensitivity of 1.00, specificity of 0.42, positive predictive value of 0.46 and negative predictive value of 1.00. An area under the receiver operating curve of 0.68 was calculated.
Conclusion:
S-100B is a valuable tool to rule out patients with pathological CCT findings in a collective of paediatric patients with MTBI. Elevations of S-100B do not necessarily lead to a pathological finding in the CT scan, but values below the cut-off safely rule out the evidence of intracranial lesions.
