Biochemical markers of traumatic brain injury

Background: Currently used clinical and radiological findings of particularly mild traumatic brain injury have limited diagnostic and prognostic value. Methods and results: We conducted a systematic review of selected primary clinical studies on biochemical markers of traumatic brain injury in the last to years, using an electronic search of the National Library of Medicine's database MEDLINE. The most explored and clinically relevant biochemical markers of acute brain injury are protein S100B, neuron-specific enolase and glial fibrillary acidic protein. In addition, novel markers such as spectrin breakdown product, c-tau and amiloid-b are presented. Based on clinical trials, the rationale for their use in the context of severity of traumatic brain injury is outlined. Conclusions: Measurement of biochemical markers of brain injury should be introduced in the clinical management of mild traumatic brain injury. The predictive value of current clinical and radiological findings can be markedly improved by the determination of biochemical markers in mild and severe traumatic brain injury.