Citation

Harrington MG. EBioMedicine 2020; 56: e102798.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.ebiom.2020.102798

PMID

32502963

Abstract

The need for objective prognostic biomarkers to help in the clinical management of head injury is huge: missed diagnoses and different injuries and susceptibilities limit efforts to predict consequences, advise victims, and offer useful prognosis. Most traumatic brain injury (TBI) is represented by concussion or mild TBI, for which there are no simple, objective, reliable tests [1]. The long-term consequence of chronic traumatic encephalopathy (CTE) [2] is not currently predict- able except from awareness that repetitive trauma from contact sports increases risk [3]. CTE is just the tip of the iceberg: mild TBI affects an estimated 42 million individuals annually [4]. We need objective bio- markers to help patient management across the entire spectrum of head injury, from mild to major, acute to chronic.

Triage in the Emergency Departments (ED) for TBI is and will remain, for the foreseeable future, a clinical decision. The primary issue is whether a significant structural brain lesion requires in- patient observation or possible neurosurgical intervention and inten- sive care. Along with clinical assessment, computerised tomography (CT) is the principal additional predictor for management choices [5]; absence of any structural abnormality such as hemorrhage or brain shift usually results in a short visit or discharge. Of many approaches to find additional prognostic indicators, blood is a widely investigated source, with components added from damaged brain. An increase in several proteins after mild TBI has been replicated across multiple research groups...

Language: en