Serum markers of brain damage and outcome prediction in patients after severe head injury.

The objective of the study was to investigate the validity of outcome prediction after severe head injury using serum levels of S-100B protein and neuron specific enolase. Eighty-two patients with severe head injury were included in this prospective study. Venous blood samples were taken after admission and every 24 h for a maximum of 10 consecutive days. For values of S-100 from 0 to 2.5 micrograms/l, and for values of NSE from 0 to 100 micrograms/l the sensitivity and specificity of incremental values as a predictor of unfavourable outcome were calculated and Receiver Operator Characteristics curves were plotted. Serum S-100 protein was found to be clearly superior to neuron specific enolase in terms of predicting outcome with higher specificity, sensitivity, positive and negative predictive value. According to our experience, S-100B protein represents the most promising serum marker of brain cell damage currently under investigation.