Traumatic brain damage in minor head injury: relation of serum S-100 protein measurements to magnetic resonance imaging and neurobehavioral outcome

Neurosurgery. 1999 Sep;45(3):468-75; discussion 475-6. doi: 10.1097/00006123-199909000-00010.


Objective: The present study was conducted to validate S-100 protein as a marker of brain damage after minor head injury.

Methods: We studied 50 patients with minor head injuries and Glasgow Coma Scale scores of 13 to 15 in whom computed tomographic scans of the brain revealed no abnormalities. Serum levels of S-100 protein were measured at admittance and hourly thereafter until 12 hours after injury. Magnetic resonance imaging and baseline neuropsychological examinations were performed within 48 hours, and neuropsychological follow-up was conducted at 3 months postinjury.

Results: Fourteen patients (28%) had detectable serum levels of S-100 protein (mean peak value, 0.4 microg/L [standard deviation, +/- 0.3]). The S-100 protein levels were highest immediately after the trauma, and they declined each hour thereafter. At 6 hours postinjury, the serum level was below the detection limit (0.2 microg/L) in five (36%) of the patients with initially detectable levels. Magnetic resonance imaging revealed brain contusions in five patients, four of whom demonstrated detectable levels of S-100 protein in serum. The proportion of patients with detectable serum levels was significantly higher when magnetic resonance imaging revealed a brain contusion. In patients with detectable serum levels, we observed a trend toward impaired neuropsychological functioning on measures of attention, memory, and information processing speed.

Conclusion: Determination of S-100 protein levels in serum provides a valid measure of the presence and severity of traumatic brain damage if performed within the first hours after minor head injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • Brain / diagnostic imaging*
  • Brain / pathology*
  • Brain Injuries / blood
  • Brain Injuries / diagnosis*
  • Brain Injuries / etiology*
  • Brain Injuries / physiopathology
  • Child
  • Craniocerebral Trauma / blood
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / physiopathology*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Language
  • Magnetic Resonance Imaging
  • Male
  • Memory
  • Middle Aged
  • Neuropsychological Tests*
  • Patient Selection
  • Prospective Studies
  • Reproducibility of Results
  • S100 Proteins / blood*
  • Time Factors
  • Tomography, X-Ray Computed


  • Biomarkers
  • S100 Proteins