Biochemical serum markers for brain damage: A short review with emphasis on clinical utility in mild head injury

Purpose. To provide an overview of clinical research on the use of biochemical serum markers for traumatic brain injury (TRI) in the evaluation of patients with mild head injuries (MHI). Methods. The MEDLINE database was searched for publications on biochemical serum markers of TBI until August 2002. Clinical studies addressing their use in MHI were reviewed. Results. Desirable characteristics for biochemical serum markers of TBI were identified. Creatine kinase isoenzyme 1313 (CK-BB), neuron specific enolase (NSE) and S-100B protein have been most extensively studied. The sensitivity and specificity of CK-BB is inadequate for use as an indicator of traumatic brain injury. Serum levels of NSE do not correspond to the amount of TBI, probably because of its long (20 h) half-life. S-100B serum levels are correlated to both clinical measures of injury severity, neuroradiological findings and outcomes in several studies from different authors. Conclusion. Currently, S-100B protein is the most promising marker for evaluation of TBI in patients with MHI