The Prognostic Value of NSE and S100B From Serum and Cerebrospinal Fluid in Patients With Spontaneous Subarachnoid Hemorrhage

Abstract

Neuron-specific enolase (NSE) and S100B protein have been shown to be increased in cerebrospinal fluid (CSF) and serum of patients suffering from subarachnoid hemorrhage. This study was designed to evaluate the accuracy of NSE and S100B from CSF and serum for the prognosis of outcome and the detection of cerebral infarction, vasospasm and intracranial hypertension. In 55 patients with spontaneous subarachnoid hemorrhage and requiring external ventricular drainage the concentrations of NSE and S100B were determined daily from the serum and the CSF from admission until day 8. At ICU discharge patients' outcome was assessed by the Glasgow outcome scale and occurrence of cerebral infarction, vasospasm and intracranial hypertension were registered. Mean and peak values of each parameter for each patient were calculated. For accuracy assessment receiver operating characteristics were used. Bad outcome (Glasgow outcome scale 1 to 3) was found in 33 patients. Cerebral infarction, vasospasm, and intracranial hypertension were found in 31 (56%), 34 (62%), and 36 (65%) patients. Mean and peak values of NSE CSF (P<0.001), S100B CSF (P<0.001), and S100B serum (P<0.001) but not of NSE serum provided the ability to distinguish between patients with good and bad outcome. The accuracy of NSE CSF and S100B CSF did not differ significantly from that of S100B serum. NSE CSF (P<0.001), S100B CSF (P<0.001), and S100B serum (P<0.001) allowed the detection of cerebral infarction and intracranial hypertension. Cerebral vasospasm was detected by none of the parameters. In conclusion, NSE CSF, S100B CSF, and S100B serum provide similar prognostic values for outcome, intracranial hypertension and cerebral infarction. Significantly lower accuracy was found for NSE serum.

CSF S100B in patients treated by endovascular coiling or surgical clipping after aneurysmal subarachnoid hemorrhage and its correlation to cerebral vasospasm

“…Within the study period, the concentration of mean CSF S100B decreased tardily over time after rupture and be higher in the high grade group than that in the low grade group, which is consistent with some previous studies [15,25,26]. Brain damage, which causes high S100B level, may be highly related to the CVS.…”

“…In the past few decades, the concentration of S100B is reported to be positively correlated with cerebral injury level after aSAH [15,16]. Treatment modalities of aSAH is closely related to cerebral injury levels, but the difference of CSF S100B of patients with treatment modalities is not very clear.…”

Lack of association of S100β and neuron-specific enolase with mortality in critically ill patients

“…Both NSE and S100b can predict outcomes in critically ill neurologic patients. [14][15][16] In critically ill patients without evident brain injury, increased S100b values correlate positively with lactate levels and negatively with mean arterial pressure (MAP) and pH. 17 In patients with sepsis, higher levels of S100b, but not NSE, have been reported in those patients who died early (first 4 days), but not in those who died late.…”

Curative effect of surgery combined with nerve growth factor preparation treatment of acute cerebral hemorrhage

“…S100β and NSE are the marker molecules positioning in neurons, the former is a kind of calcium-binding protein, and it is closely related to the regulation of Ca2+ homeostasis within neurons and the regulation of cytoskeleton elements; the latter is the key enzyme of glycolysis function way in neurons, and it is of great significance to the neuron ATP production and function [17]. GFAP and MBP are the marker molecules positioning in the glial cells, and they are mainly involved in the regulation of glial cell structure stability and skeleton structure formation [18][19][20]. In order to define the recovery of neurological function in convalescence after acute cerebral hemorrhage, serum nerve injury-related molecule levels were analyzed in the study to reflect the degree of nerve damage, and then assess the recovery of neurological function.…”