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Blood test for brain injuries gains momentum
Date:3/31/2009

vice. If a person falls and gets a head injury in Munich, Germany, during Oktoberfest, for example, a neurosurgeon is on duty within 500 meters of the beer tent, ready to administer the blood test, Bazarian said.

But in the United States, the current, accepted standard screening tool for head injuries is still the CT scan, which shows bleeding in the brain but does not detect more subtle injury to the brain's neurons, which can result in lasting neurological defects. In fact, 95 percent of CT scans look normal for patients with a relatively mild but potentially life-altering injury, Bazarian said.

There are more than 1 million emergency visits annually for traumatic brain injury (TBI) in the U.S. The majority of these visits are for mild injuries, primarily the result of falls and motor vehicle crashes. The challenge for doctors is to identify which of these patients has an acute, traumatic intracranial injury, something that is not always evident, and which patients can be observed and sent home.

Widespread use of the blood test could result in a 30 percent reduction of CT scans, according to the report by the national panel of brain experts, which published updated clinical guidelines in the December 2008 Annals of Emergency Medicine, and the April 2009 Journal of Emergency Nursing.

Bazarian and colleague Brian J. Blyth, M.D., assistant professor of Emergency Medicine at URMC, additionally found that the S-100B test can relay critical information about how the blood-brain barrier (BBB) is functioning after a head injury. Blyth was the first author on this study, reported electronically March 3, 2009, in the Journal of Neurotrauma.

In the context of head injuries, the BBB acts like a gate between the brain tissue and peripheral circulation. The gate often opens after injury, but not always. Knowing the status of the BBB helps doctors to decide if medications given to repair damage will actually reach the
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Contact: Leslie Orr
Leslie_Orr@urmc.rochester.edu
585-275-5774
University of Rochester Medical Center
Source:Eurekalert

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