Correlation of computed tomography findings and serum brain damage markers following severe head injury

Acta Neurochir (Wien). 1998;140(8):787-91; discussion 791-2. doi: 10.1007/s007010050180.


The objective of our study was to investigate the association between the initial levels of serum S-100B protein and neuron specific enolase and the severity of radiologically visible brain damage and outcome after severe head injury. Admission computed tomography (CT) scans of forty-four patients with severe head injury were analysed. Initial levels of S-100B protein and neuron specific enolase were compared between the different outcome groups at 6 month, the different categories of the Marshall classification, the presence of traumatic subarachnoid haemorrhage, the type of haematoma and the volume of contusion. Serum S-100B was significantly higher in patients with unfavourable outcome (1.1 micrograms/l versus 0.3 microgram/l, p < 0.005, Mann-Whitney U test). In diffuse injury, unfavourable outcome significantly increased with higher Marshall grades (p < 0.05). There was a significant correlation between the four grades of diffuse injury and initial serum S-100B protein (r = 0.48, p < 0.001). Patients with focal mass lesions and a favourable outcome after 6 month had significantly lower S-100B values than those who had an unfavourable outcome (0.51 microgram/l versus 1.3 micrograms/l, p < 0.05). A significant correlation was demonstrated between the volume of contusion visible on CT scans and serum S-100B (r = 0.58, p < 0.001). In our study, initial serum S-100B protein was a powerful predictor of outcome even within the same category of radiologically visible brain damage. Serum S-100B protein may provide independent information about the severity of primary brain damage after head injury.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Brain Damage, Chronic / blood*
  • Craniocerebral Trauma / blood*
  • Craniocerebral Trauma / complications
  • Craniocerebral Trauma / diagnostic imaging*
  • Craniocerebral Trauma / physiopathology
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Nerve Growth Factors
  • Phosphopyruvate Hydratase / blood*
  • Prospective Studies
  • S100 Calcium Binding Protein beta Subunit
  • S100 Proteins / blood*
  • Subarachnoid Hemorrhage / blood
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology
  • Tomography, X-Ray Computed*


  • Biomarkers
  • Nerve Growth Factors
  • S100 Calcium Binding Protein beta Subunit
  • S100 Proteins
  • Phosphopyruvate Hydratase