Biomarkers of Acute Brain Injury in the Emergency Department

Abstract

The diagnosis of acute brain injury in the acute care setting is based on neurological examination and neuroimaging tools such as computed tomography CT scanning and magnetic resonance imaging MRI . However, there are limitations to both CT and MRI scanning. The lack of objective, noninvasive and readily accessible clinical tools to detect injury has left clinicians with uncertainty about how to best identify and treat these conditions. It is also very difficult for patients and their families who struggle to better understand the deficits they deal with on a daily basis. There have been many studies exploring many promising biomarkers during the last decade. Despite the large number of published studies there is still a lack of any Food and Drug "dministration FD" -approved biomarkers for brain injury in adults and children. Given all of these researches, there is now an important need to validate and introduce them into the clinical setting. This chapter reviews commonly studied biomarkers for acute brain injury in humans, with an emphasis on traumatic brain injury and stroke.

Brain-originated peptides as possible biochemical markers of traumatic brain injury in cerebrospinal fluid post-mortem examination

“…Brain-originated peptides still have considerable diagnostic and therapeutic value because they reflect core elements of the TBI and supplement functional and imaging-based assessments. Currently the tentative biofluid markers for acute brain injury in the clinical setting include biomarkers of astroglial injury: S-100β, GFAP; biomarkers of neuronal injury: neuron specific enolase (NSE), ubiquitin C-terminal hydrolase (UCH-L1); biomarkers of axonal injury: α-II-spectrin (A2S), MAPT, and neurofilament heavy (NFH) and light (NFL) chains [14,17,33]. Selected potential TBI markers and their sources are illustrated in Figure 1.…”