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Updated: May 22, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Serum S100B determination in the management of pediatric mild traumatic brain injury
Damien Bouvier1, Mathilde Fournier, Jean-Benoît Dauphin
1Clermont-Ferrand Teaching Hospital, Biochemistry Department, Clermont-Ferrand, France.
Insights
Serum S100B measurement in pediatric mild traumatic brain injury (mTBI) can help identify patients needing cranial CT scans. This biomarker aids in reducing unnecessary imaging and associated costs in children.
Area of Science:
- Pediatric Emergency Medicine
- Neurotrauma Biomarkers
- Clinical Diagnostics
Background:
- The utility of serum S100B in managing mild traumatic brain injury (mTBI) remains debated.
- This study evaluates S100B in the largest pediatric cohort to date.
Purpose of the Study:
- To assess the diagnostic value of serum S100B in children with mTBI.
- To determine if S100B can aid in decisions regarding cranial computed tomography (CCT) and hospitalization.
Main Methods:
- Prospective enrollment of 446 children under 16 presenting within 3 hours of TBI.
- Serum S100B levels measured and correlated with TBI severity (Masters classification), CCT findings, and clinical evolution.
- Glasgow Coma Scale (GCS) and Masters classification used to categorize TBI severity.
Main Results:
- S100B concentrations significantly differed across Masters TBI severity groups (P < 0.05).
- S100B demonstrated 100% sensitivity for detecting CT-positive findings and predicting adverse clinical evolution in specific subgroups.
- S100B showed moderate specificity (33-36%) for these outcomes.
Conclusions:
- Serum S100B measurement within 3 hours of pediatric mTBI shows potential for reducing unnecessary CCT scans.
- Utilizing S100B may help avoid radiation exposure and decrease healthcare costs associated with hospitalization and imaging.
Background:
The place of serum S100B measurement in mild traumatic brain injury (mTBI) management is still controversial. Our prospective study aimed to evaluate its utility in the largest child cohort described to date.
Methods:
Children younger than 16 years presenting at a pediatric emergency department within 3 h after TBI were enrolled prospectively for blood sampling to determine serum S100B concentrations. The following information was collected: TBI severity determined by using the Masters classification [1: minimal or Glasgow Coma Scale (GCS) 15, 2: mild or GCS 13-15, and 3: severe or GCS <13]; whether hospitalized or not; good or bad clinical evolution (CE); whether cranial computed tomography (CCT) was prescribed; and related presence (CCT+) or absence (CCT-) of lesions.
Results:
For the 446 children enrolled, the median concentrations of S100B were 0.21, 0.31, and 0.44 μg/L in Masters groups 1, 2, and 3, respectively, with a statistically significant difference between these groups (P < 0.05). In Masters group 2, 65 CCT scans were carried out. Measurement of S100B identified patients as CCT+ with 100% (95% CI 85-100) sensitivity and 33% (95% CI 20-50) specificity. Of the 424 children scored Masters 1 or 2, 21 presented "bad CE." S100B identified bad CE patients with 100% (95% CI 84-100) sensitivity and 36% (95% CI 31-41) specificity. Of the 242 children hospitalized, 81 presented an S100B concentration within the reference interval.
Conclusions:
Serum S100B determination during the first 3 h of management of children with mTBI has the potential to reduce the number of CCT scans, thereby avoiding unnecessary irradiation, and to save hospitalization costs.
