Neuroprotein s-100B -- a useful parameter in paediatric patients with mild traumatic brain injury?

Acta Paediatr. 2009 Oct;98(10):1607-12. doi: 10.1111/j.1651-2227.2009.01423.x.

Abstract

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.

MeSH terms

  • Adolescent
  • Area Under Curve
  • Biomarkers / blood
  • Brain Injuries / blood
  • Brain Injuries / diagnosis*
  • Child
  • Child, Preschool
  • False Positive Reactions
  • Female
  • Humans
  • Infant
  • Male
  • Prospective Studies
  • Reference Values
  • S100 Proteins / blood*
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods*

Substances

  • Biomarkers
  • S100 Proteins