Diagnostic Blood Test (S-100B) Screens for Brain Injury or Damage

Severe head injuries (scalp, skull or brain 1) commonly cause disability and death for children and adults. 3 More males than females risk head injury and higher probability among adolescent population. Frequently reported during afternoons and early evening hours (spring and summer months) children outdoor activities including skating, skateboarding and riding bicycles attributed to head injuries. 16 "More than one million children sustain brain injuries every year and approximately 165,000 require hospitalization." 2 Severe head injuries cause bleeding in or around the brain and skull fractures, requiring immediate medical attention. Computer tomography (CT) scan or computerized axial tomography (CAT - three dimensional picture images) diagnostic scan for head injuries: Evaluates the seriousness of a head injury and the prognosis for recovery, especially during and after treatment. 1 Researchers investigating a new blood test focusing on an increase level of a protein (S-100B) found in nerve cells, released in proportion to the severity of a brain injury. High level of S-100B (blood test) unfortunately predicts a fatal outcome (in all cases) or therapy (treatment) not succeeding. Recovering from a brain injury S-100B level decreases. 3

Most bumps and knocks to the head do not cause brain injury, surrounding the brain layers of tissue (menignes) that contains cerebrospinal fluid cushions the brain. Traumatic brain injury or severe brain injuries (70% of the time) related to vehicle crashes. Other common causes (related to brain injury) are falls in the home, physical assaults, mishaps during sports, recreational activities, workplace (for example, while operating machinery) and firearms. Common symptoms of a head injury include: Headaches (light or severe), confusion, nausea, trouble sleeping, irritable, depression, anxiety, poor memory, and fatigue. When periods of unconscious occur from a head injury, requires immediate medical attention. Symptoms such as movement, speech, hearing and other functions maybe permanently impaired as result of a head injury. 4

A severe head injury can cause a concussion (Loss of memory or awareness for minutes or hours after a traumatic event) skull fractures and blood clots inside and around the brain, not treated immediately or untreatable is fatal. Blood clots around or inside the brain: Epidural hematoma (Blood clot develops underneath the skull or on top of the dura, the tough or outermost layer surrounding the brain.), subdural hematoma (Outside of the brain a blood clot occurs underneath the skull and below the dura), Intracerebral hematoa (" A confusion is a bruise to the brain itself. A confusion causes bleeding and swelling inside of the brain around the area where the head was struck."), and diffuse axonal injury(DAI - brain is shaken severely during an accident, fall or shaken baby syndrome causing injury to many parts of the brain, frequently for a prolonged period of time in a coma). Diagnostic imaging devices and x-rays show the extent of brain injury and fractures. 5

Minor head injuries cause no symptoms except for pain on the site of the injury. Analgesics such as acetaminophen are taken to relieve minor head injury pain. However, important to note, bleeding in the brain or skull is worsened, when aspirin or other non-steroidal anti - inflammatory drugs are taken. 4

Wearing protective head gear and seat belts prevent or lessens the impact suffered from sustaining a severe head injury. 5

S-100B calcium - binding protein ("It is termed "S100" because it is partially soluble in 100% saturated solution of ammonium sulfate.") located in the brain cerebrospinal fluid ("Clear, colorless liquid that fills and surrounds the brain and the spinal cord and provides a mechanical barrier against shock." 6). 7

S-100B protein sustains the survival and regeneration of neurons (Neurons are cells in the nervous system that process and transmit electro-chemical signals in the brain and other locations. 18) in the brain. 17

In sixteen European countries, S-100B Blood test a routine screen for brain injury: S-100B serves as a bio-marker for detecting increase level in the blood result of a brain injury. Two published

S-B100 serum protein blood test studies by Dr. Jeffrey Bazarian, M.P.H associate professor of Emergency Medicine, Neurology and Neurosurgery at University of Rochester Medical Center and co-author of both studies, find supporting evidence S-100B Blood test confirms CT scan, detecting hemorrhage and skull fracture within 20 minutes (get results): When the blood test is taken within four hours of the injury. Results of S-100 Blood test could prevent brain invasive surgical procedure called ventriculostomy (Evaluates how the blood-brain-barrier (BBB) functions normally by regulating the interface between the bloodstream and the brain. 10) Results of pilot program among 20 patients, confirmed S-100B Blood test accurately predicted within 12 hours after an injury, blood-brain-barrier functioned normally. The S-B100 Blood test spare patient's exposure to radiation scan tests.

According to published reports (In December 2008 Annals of Emergency Medicine and April 2009 - Journal of Emergency Nursing) by the national panel of brain experts, estimate S-100B Blood test could reduce by thirty percent CT scans. 8 Presumably the blood test is a preferred test for pregnant women than a radiation scan, exposing the fetus to health concerns.

During 2009, physicians at six Emergency Departments including Memorial Hospital in Rochester, evaluate the accuracy of S-B100 Blood test among 1,500 patients. "Scientists plan to use the data to apply for U.S. Food and Drug Administration approval". 8

According to research investigators elevated serum protein in S-B100 Blood tested confirm children diagnosed with psychosis ("Psychosis is a symptom or feature of mental illness typically characterized by radical changes in personality, impaired functioning, and a distorted or non-existent sense of objective reality." 12). 13 Several studies validate increase values of S-B100 Blood test to neurological diseases including cerebral hypoxia and stroke. 14 Also, Brains of Alzheimer's disease and Down syndrome have elevated S-B100 protein. 15

Contrary to positive reviews of S-B100 Blood Test: "S100B increases have been found without brain injury after both cardiac surgery and trauma (patients without head injury)." A study of 55 trauma patients supports this finding. 11

Currently, the Food and Drug Administration has not approved S-100B Blood test standard screening for head injuries. In the U.S.A. physicians still recommend CT-scan (detects bleeding in the brain), not 100% reliable for detecting slight injury's to the brain's neurons (About 100 billion neurons receive and transmit nerve signals to and from the brain at up to 200 mph. 9), leading to permanent neurological defects.8

References:

1.) HEAD INJURY - http://www.faqs.org/health/Sick-V2/Head-Injury.html

2.) Children and Traumatic Brain Injury - http://www.anapolschwartz.com/practices/medical-malpractice/birth-injury/children-brain-injury.asp

3.) Blood Test Points To Brain Damage After Head Injury - http://www.personalmd.com/news/n0913092702.shtml

4.) Introduction - http://www.merck.com/mmhe/sec06/ch087/ch087a.html

5.) Head Injury - http://medicalcenter.osu.edu/patientcare/healthcare_services/nervous_system/injury/Pages/index.aspx

6.) cerebrospinal fluid - http://www.britannica.com/EBchecked/topic/103430/cerebrospinal-fluid

7.) Evidence for a wide estra-astrocytic distribution of S100B in human brain - http://www.biomedcentral.com/1471-2202/8/2

8.) Blood test that predicts seriousness of a head injury gains momentum - http://www.news-medical.net/?id=47679

9.) The Brain - http://www.enchantedlearning.com/subjects/anatomy/brain/Neuron.shtml

10.) Findings Could Lead to New Treatments for Brain Disorders - http://www.umm.edu/news/releases/bloodbrain.htm

11.) Serum makers of severe traumatic brain injury: Are they useful? - http://www.ijccm.org/article.asp?issn=0972-5229;year=2004;volume=8;issue=3;spage=190;epage=193;aulast=Pelinka

12.) psychosis - http://www.answers.com/topic/psychosis

13.) Inflammation and Blood-Brain Barrier Dysfunction May Contribute to Psychosis - http://www.neuropsychiatryreviews.com/08dec/InflamBlood-Brain.html

14.) Serum S100B as a biochemical marker of neurological complications in intensive care patients - http://ccforum.com/content/6/S1/P56

15.) Disease relevance of S100B - http://www.wikigenes.org/e/gene/e/6285.html

16.) Head Injury - http://www.chw.org/display/PPF/DocID/22525/router.asp

17.) Possible Protein Market for Schizophrenia Symptoms - http://www.unisci.com/stories/20012/0621012.htm

18.) Neuron - http://en.wikipedia.org/wiki/Neuron