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Updated: May 21, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Ability of S100B to predict severity and cranial CT results in children with TBI
Lynn Babcock1, Terri Byczkowski, Sohug Mookerjee
1Division of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. lynn.babcock@cchmc.org
Insights
Elevated S100B levels in children with traumatic brain injury (TBI) may indicate injury severity and abnormal CT scans. However, S100B is not a reliable standalone screening tool for identifying children with mild TBI requiring a CT scan.
Area of Science:
- Pediatric Emergency Medicine
- Neurotrauma Biomarkers
- Diagnostic Accuracy Studies
Background:
- Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in children.
- Accurate and timely assessment of TBI severity and the need for neuroimaging is crucial in pediatric patients.
- S100B protein is a potential biomarker for brain injury, but its utility in pediatric TBI requires further evaluation.
Purpose of the Study:
- To assess the predictive capability of S100B protein levels for TBI severity in children.
- To determine if S100B can predict abnormal cranial CT findings in pediatric TBI cases.
- To evaluate the clinical utility of S100B as a screening tool for cranial CT in mild TBI.
Main Methods:
- Secondary analysis of a cohort of pediatric patients (<19 years) presenting with TBI within 6 hours of injury.
- Inclusion criteria: cranial CT scan and blood drawn for S100B analysis.
- Statistical analysis to compare S100B levels based on TBI severity (GCS) and CT findings.
Main Results:
- S100B levels were significantly higher in children with moderate/severe TBI compared to mild TBI (0.281 vs 0.053 µg/L).
- Elevated S100B levels correlated with abnormal cranial CT findings (0.210 vs 0.036 µg/L, p=0.03).
- S100B showed moderate predictive ability for abnormal CT (AUC=0.72) but not for patients with GCS of 15.
Conclusions:
- S100B protein shows potential in predicting TBI severity and abnormal CT scans in children.
- S100B alone may not be sufficiently clinically useful to independently screen children with mild TBI for cranial CT.
- Further research may explore S100B in conjunction with other clinical factors for improved diagnostic accuracy.
Objectives:
To evaluate the ability of S100B to predict severity of TBI and abnormal cranial CT results for children with TBI.
Methods:
This is a secondary analysis of a previously established cohort of consecutive patients presenting to the emergency department with TBI limited to children <19 years of age, who arrived within 6 hours of injury, received a cranial CT scan and consented to blood drawn for S100B.
Results:
A total of 109 children were included in this cohort. The mean S100B levels were higher in children with moderate/severe TBI as compared to children with mild TBI based GCS score (0.281 µg L(-1), 95%CI = 0.101, 0.461 vs 0.053, 95%CI = 0.010, 0.095). S100B levels were significantly elevated in children following TBI with abnormal cranial CT as compared to children with a normal cranial CT (0.210 µg L(-1), SD = 0.313 vs 0.036 µg L(-1), SD = 0.046, p = 0.03). Area under the curve for S100B was also significant (0.72, 95%CI = 0.58, 0.86) for prediction of abnormal cranial CT for children with TBI. S100B did not predict abnormal cranial CT for children following TBI with a GCS of 15 (AUC = 0.53, 95%CI = 0.36, 0.71).
Conclusions:
For children following TBI, S100B appears to predict severity of TBI; however, it may not be clinically useful as an independent screening test to select children with mild TBI who need a cranial CT.
