Summary
We investigated the time course of neuron specific enolase (NSE) and S-100 protein after severe head injury in correlation to outcome. We included 30 patients (GCS<9), who had been admitted within 5 hours after injury, in a prospective study. Blood samples were taken on admission, 6, 12. and 24 hours and every 24 hours up to the fifth day after injury. The outcome was estimated on discharge using the Glasgow Outcome Scale. 70% reached a good outcome. All concentrations of NSE and 83% of the S-100 samples were elevated concerning the first probe (30.2 μg/l NSE mean and 2.6 μg/l S-100 mean). Patients with bad outcome had an NSE concentration of 38 μg/l (mean) compared with 26.9 μg/l (mean) in patients with good outcome. Patients with bad outcome had an S-100 concentration of 4.9 μg/l (mean) compared with 1.7 μg/l (mean) in patients with good outcome (p<0.05). The mean values of NSE and S-100 decreased during the first 5 days. Four patients with increasing intracranial pressure showed a quick increasing concentration of NSE, in two patients the S-100 level showed a slower rise. The NSE serum levels did not correlate with intracranial pressure values. Our results show that the first serum concentration of S-100 seems to be predictive for outcome after severe head injury.
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Barone FC, Clark RK, Price J, White RF, Feuerstein GZ, Storer LS, Ohlstein EH (1993) Neuron-specific enolase increase in cerebral and systemic circulation following focal ischemia. Brain Res 623: 77–82
Cunningham RT, Young IS, Winders J, O'Kane MJ, Kinstry S, Johnston CF, Dolan OM, Hawkins SA, Buchanan KD (1991) Serum neurone specific enolase (NSE) levels as an indicator of neuronal damage in patients with cerebral infarction. Eur J Clin Invest 21: 497–500
Hardemark HG, Ericsson N, Kotwica Z, Rundström G, Mendel-Hartwig I, Olsson Y, Pahlman S, Persson L (1989) S-100 protein and neuron-specific enolase in CSF after experimental traumatic or focal ischemic brain damage. J Neurosurg 71: 727–731
Hay E, Royds JA, Davies-Jones GAB, Lewtas NA, Timperley WR, Taylor CB (1984) Cerebrospinal fluid enolase in stroke. J Neurol Neurosurg Psychiatry 47: 724–729
Horn M, Seger F, Schlote W (1995) Neuron-specific enolase in gerbil brain and serum after transient cerebral ischemia. Stroke 26: 290–297
Ingebrigtsen T, Rommer B (1996) Serial S-100 protein measurements related to early magnetic resonance imaging after minor head injury. J Neurosurg 85: 945–948
Jennett B, Bond M (1975) Assessment of outcome after severe brain damage: a practical scale. Lancet 1: 480–484
Kruse A, Cesarini KG, Bach FW, Person L (1991) Increase of neuron-specific encolase, S-100 protein, creatine kinase BB isoenzyme in CSF following intraventricular catheter implantation. Acta Neurochir (Wien) 110: 106–109
Marangos PJ, Schmechel D, Parma AM, Clark RL, Goodwin FK (1979) Measurement of neuron-specific (NSE) and non-neuronal (NNE) isoenzymes of enolase in rat, monkey and human nervous tissue. J Neurochem 33: 319–329
Marshall LF, Marshall SB, Klauber MR, Van Berkum Clark M, Eisenberg HM, Jane JA, Luerssen TG, Marmarou A, Foulkes MA (1991) A new classification of head injury based on computerized tomography. J Neurosurg 75: S15-S20
Missler U, Wiesmann M (1995) Measurement of S-100 protein in human blood and cerebrospinal fluid: analytical method and preliminary clinical results. Eur J Clin Chem Clin Biochem 33: 743–748
Nara T, Nozaki H, Nakae Y, Arai T, Ohashi T (1988) Neuron-specific enolase in comatose children. AJDC 142: 173–174
Prange HW (1994) Pathophysiologie, Therapie und Prognose des hypoxisch-ischämischen Hirnschadens. Z Kardiol 83: 127–134
Persson L, Hardemark HG, Gustafsson J, Rundström G, Mendel-Hartvig I, Esscher T, Pahlman S (1987) S-100 protein and neuron-specific enolase in cerebrospinal fluid and serum: markers of cell damage in human central nervous system. Stroke 18: 911–918
Skogseid LM, Nordby HK, Urdal P, Paus E, Lilleaas F (1992) Increased serum creatine kinase BB and neuron specific enilase following head injury indicates brain damage. Acta Neurochir (Wien) 115: 106–111
Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2: 81–84
Yamazaki Y, Yada K, Morii S, Kitahara T, Ohwada T (1995) Diagnostic significance of serum neuron-specific enolase and myelin basic protein assay in patients with acute head injury. Surg Neurol 43: 267–271
Vaagenes P, Urdal P, Melvoll R, Valnes K (1986) Enzyme level changes in the cerebrospinal fluid of patients with acute stroke. Arch Neurol 43: 357–362
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Woertgen, C., Rothoerl, R.D., Holzschuh, M. et al. Comparison of serial S-100 and NSE serum measurements after severe head injury. Acta neurochir 139, 1161–1165 (1997). https://doi.org/10.1007/BF01410977
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DOI: https://doi.org/10.1007/BF01410977