Biological markers and severe head trauma. Where are we?

Abstract

Traumatic brain injury (TBI) constitutes a major health and socioeconomic problem throughout the world. Despite the significant advances in neuroradiology and cerebral monitoring it is still difficult to measure the degree of primary brain injury and continuing secondary damage with Glasgow Coma Scale score or the initial computed tomography. Predicting prognosis of TBI patients in early stages has a vital importance and is difficult in some instances. The present review shows that there has been an increasing interest in biochemical markers for traumatic brain injury during the last years. The potential correlation of markers with injury and outcome measures in severe head injury is promising.

Resumo

O traumatismo cranioencefálico constitui um grave problema socioeconômico em todo o mundo. Apesar dos avanços em neurorradiologia e neuromonitorização, ainda é difícil mensurar a injúria primária e prever os danos secundários dos pacientes com base somente na Escala de Coma de Glasgow ou na tomografia de crânio da admissão. Predizer o prognóstico dos pacientes ainda em uma fase inicial é de vital importância, porém muitas vezes difícil. A presente revisão mostra que há interesse cada vez maior nos marcadores biológicos relacionados ao trauma de crânio. A potencial correlação dos biomarcadores da injúria primária com o desfecho dos pacientes com traumatismo craniano grave é promissora.

Keywords

Biological markers - craniocerebral trauma - prognosis

Palavras-chave

Marcadores biológicos - traumatismos craniocerebrais - prognóstico

¹Neurosurgeon. Post-Graduation Program. University of Sao Paulo, Brazil.

²Neurosurgeon. Neurosurgery Division of Hospital das Clínicas, University of Sao Paulo, Brazil.

³Nurse. University of Ponta Grossa (UEPG). Pharmacy Student. Cescage. Ponta Grossa, Brazil.

⁴Neurosurgeon. Head of Neurovascular Group and Supervisor of Division of Neurosurgery of Hospital das Clínicas, University of Sao Paulo, Brazil.

⁵Neurosurgeon. Head of Neurotraumatology Group of Neurosurgery Division of Hospital das Clínicas, University of Sao Paulo, Brazil.

⁶Neurosurgeon. Chairman. Division of Neurosurgery Hospital das Clínicas, University of Sao Paulo, Brazil.