Summary
Background. Despite the major progress in neurophysiological monitoring, there are still difficulties in the early identification and quantification of cerebral damage after a stroke. In this prospective study we examined the associations between serum S-100B protein, a serum marker of brain injury, and initial neurological-neuroimaging severity, secondary deterioration, external ventricular drainage (EVD: therapeutic intervention) and outcome in patients with subarachnoid haemorrhage (SAH).
Method. We recorded all pertinent clinical data of 52 patients with SAH and measured S-100B serum levels on admission and every 24 h for a maximum of 9 consecutive days. Mann–Whitney U-test and Kruskal Wallis analysis were employed to assess the association of S-100B levels with all variables of interest. Log-rank test was used to evaluate survival and Cox’s proportional hazard regression analysis to define the significant predictors of survival rate.
Findings. Admission S-100B was statistically significantly associated with initial neurological status, neuroimaging severity, and one-year outcome (p = 0.0002, 0.001, and 0.017, Kruskal Wallis analysis). Admission S-100B above 0.3 µg/L predicted unfavourable outcome (p < 0.0001, log rank test) and constituted an independent predictor of short-term survival (p = 0.035 Cox’s proportional hazard regression analysis) with a hazard ratio of 2.2 (95% C.I.: 1.06–4.6) indicating a more than doubling of death probability. Secondary neurological deterioration associated with S-100B increase (p < 0.0001) and external ventricular drainage (EVD) with S-100B reduction (p = 0.003, Wilcoxon signed rank test).
Conclusions. Serum S-100B protein seems to be a useful biochemical indicator of neurological – neuroimaging severity, secondary deterioration, EVD (therapeutic intervention), and outcome in patients with SAH.
Similar content being viewed by others
References
K Atkinson (1993) Elementary numerical analysis John Wiley & Sons Inc. New York 1–448
JI Ausman FG Diaz GM Malik BT Andrews PW McCormick G Balakrishnan (1989) ArticleTitleManagement of cerebral aneurysms: Further facts and additional myths Surg Neurol 32 21–35 Occurrence Handle2660308 Occurrence Handle10.1016/0090-3019(89)90031-1 Occurrence Handle1:STN:280:DyaL1M3otl2jtw%3D%3D
WJ Conover (1980) Practical nonparametric statistics John Wiley & Sons Inc New York 1–584
R Deruty I Pelissou-Guyotat C Mottolese D Amat L Bognar (1995) ArticleTitleLevel of consciousness and age as prognostic factors in aneurysmal SAH Acta Neurochir (Wien) 132 1–8 Occurrence Handle10.1007/BF01404840 Occurrence Handle1:STN:280:DyaK2M3nsVClsA%3D%3D
J De Vries (2003) ArticleTitlePerioperative levels of S-100B protein in serum: marker for surgical manipulation and postoperative complications Minim Invas Neurosurg 46 33–36 Occurrence Handle10.1055/s-2003-37963 Occurrence Handle1:STN:280:DC%2BD3s7is1Wktg%3D%3D
CG Drake WE Hunt K Sano N Kassell G Teasdale B Pertuiset JC De Villiers (1988) ArticleTitleReport of World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale J Neurosurg 68 985–986
G Edner E Kagstom L Wellstedt (1992) ArticleTitleOverall management and surgical outcome after subarachnoid hemorrhage in a defined population Br J Neurosurg 6 409–420 Occurrence Handle1449664 Occurrence Handle1:STN:280:DyaK3s%2FotVyisw%3D%3D
OC Fagnart CJ Sindic C Laterre (1988) ArticleTitleParticle counting immunoassay of S-100 protein in serum. Possible relevance in tumors and ischemic disorders of the central nervous system Clin Chem 34 1387–1391 Occurrence Handle3292082 Occurrence Handle1:CAS:528:DyaL1cXlsVGlurk%3D
CM Fisher JP Kistler JM Davis (1980) ArticleTitleRelation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning Neurosurgery 6 1–9 Occurrence Handle7354892 Occurrence Handle10.1097/00006123-198001000-00001 Occurrence Handle1:STN:280:DyaL3c7itV2ksA%3D%3D
TP Germanson G Lanzino GL Kongable JC Torner NF Kassell (1998) ArticleTitleRisk classification after aneurysmal subarachnoid hemorrhage Surg Neurol 49 155–163 Occurrence Handle9457265 Occurrence Handle10.1016/S0090-3019(97)00337-6 Occurrence Handle1:STN:280:DyaK1c7hvVGqsw%3D%3D
HG Hardemark O Almqvist T Johansson S Pahlman L Persson (1989) ArticleTitleS-100 protein in cerebrospinal fluid after aneurysmal subarachnoid haemorrhage: relation to functional outcome, late CT and SPECT changes, and signs of higher cortical dysfunction Acta Neurochir (Wien) 99 135–144 Occurrence Handle10.1007/BF01402322 Occurrence Handle1:STN:280:DyaL1MzntFWitA%3D%3D
B Jennett M Bond (1975) ArticleTitleAssessment of outcome after severe brain damage. A practical scale Lancet 1 480–484 Occurrence Handle46957 Occurrence Handle10.1016/S0140-6736(75)92830-5 Occurrence Handle1:STN:280:DyaE2M7hsl2jsw%3D%3D
NF Kassel JC Torner EC Haley JA Jane HP Adams GL Kongable (1990) ArticleTitleThe international cooperative study on the timing of aneurysm surgery. Part 1: overall management results J Neurosurg 73 18–36
A Lagares PA Gomez RD Lobato JF Alen R Alday J Campollo (2001) ArticleTitlePrognostic factors on hospital admission after spontaneous subarachnoid haemorrhage Acta Neurochir (Wien) 143 665–672 Occurrence Handle10.1007/s007010170044 Occurrence Handle1:STN:280:DC%2BD3MvptF2iuw%3D%3D
L Persson H Hardemark G Edner E Ronne I Mendel-Hartvig S Pahlman (1988) ArticleTitleS-100 protein in cerebrospinal fluid of patients with subarachnoid haemorrhage: a potential marker of brain damage Acta Neurochir (Wien) 93 116–122 Occurrence Handle10.1007/BF01402892 Occurrence Handle1:STN:280:DyaL1M%2Fit1aqug%3D%3D
A Raabe C Grolms O Sorge M Zimmermann V Seifert (1999) ArticleTitleSerum S-100B protein in severe head injury Neurosurgery 45 477–483 Occurrence Handle10493369 Occurrence Handle10.1097/00006123-199909000-00012 Occurrence Handle1:STN:280:DyaK1MvitFWisA%3D%3D
DS Rosen LR Macdonald (2004) ArticleTitleGrading of subarachnoid hemorrhage: modification of the World Federation of Neurosurgical Societies Scale on the basis of data for a large series of patients Neurosurgery 54 566–576 Occurrence Handle15028129 Occurrence Handle10.1227/01.NEU.0000108862.32404.A5
U Schick J Dohnert JJ Meyer HE Vitzthum (2003) ArticleTitlePrognostic significance of SSEP, BAEP and serum S-100B monitoring after aneurysm surgery Acta Neurol Scand 108 161–169 Occurrence Handle12911458 Occurrence Handle10.1034/j.1600-0404.2003.00109.x Occurrence Handle1:STN:280:DC%2BD3szns1ygsg%3D%3D
LH Smit CM Korse JM Bonfrer (2005) ArticleTitleComparison of four different assays for determination of serum S-100B Int J Biol Markers 20 34–42 Occurrence Handle15832771 Occurrence Handle1:CAS:528:DC%2BD2MXls1alsrw%3D
G Stranjalis S Korfias C Papapetrou AT Kouyialis EJ Boviatsis C Psachoulia DE Sakas (2004) ArticleTitleElevated serum S-100B protein as a predictor of failure to short-term return to work or activities after mild head injury J Neurotrauma 21 1070–1075 Occurrence Handle15319006 Occurrence Handle10.1089/0897715041651088
G Stranjalis S Korfias C Psachoulia EJ Boviatsis AT Kouyialis D Protopappa DE Sakas (2005) ArticleTitleSerum S-100B as an indicator of early postoperative deterioration after meningioma surgery Clin Chem 51 202–207 Occurrence Handle15550475 Occurrence Handle10.1373/clinchem.2004.039719 Occurrence Handle1:CAS:528:DC%2BD2MXlt1ymuw%3D%3D
M Takayasu M Shibuya M Kanamori Y Suzuki K Ogura N Kageyama H Umekawa H Hidaka (1985) ArticleTitleS-100 protein and calmodulin levels in cerebrospinal fluid after subarachnoid hemorrhage J Neurosurg 63 417–420 Occurrence Handle4020469 Occurrence Handle1:STN:280:DyaL2M3mtlyltw%3D%3D Occurrence Handle10.3171/jns.1985.63.3.0417
WJ Townend MJ Guy MA Pani B Martin DW Yates (2002) ArticleTitleHead injury outcome prediction in the emergency department: a role for protein S-100B? J Neurol Neurosurg Psychiatry 73 542–546 Occurrence Handle12397148 Occurrence Handle10.1136/jnnp.73.5.542 Occurrence Handle1:STN:280:DC%2BD38njvVSrsw%3D%3D
J Van Gijn JE Bromberg KW Lindsay D Hasan M Vermeulen (1994) ArticleTitleDefinition of initial grading, specific events and overall outcome in patients with aneurismal subarachnoid hemorrhage: a survey Stroke 25 1623–1627 Occurrence Handle8042214 Occurrence Handle1:STN:280:DyaK2czhslWrtA%3D%3D
M Wiesmann U Missler D Gottmann S Gehring (1998) ArticleTitlePlasma S-100B protein concentration in healthy adults is age- and sex- independent Clin Chem 44 1056–1058 Occurrence Handle9590385 Occurrence Handle1:CAS:528:DyaK1cXivFKmurs%3D
M Wiesmann U Missler H Hagenstrom D Gottmann (1997) ArticleTitleS-100 protein plasma levels after aneurysmal subarachnoid haemorrhage Acta Neurochir (Wien) 139 1155–1160 Occurrence Handle10.1007/BF01410976 Occurrence Handle1:STN:280:DyaK1c7ktVSgtw%3D%3D
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stranjalis, G., Korfias, S., Psachoulia, C. et al. The prognostic value of serum S-100B protein in spontaneous subarachnoid haemorrhage. Acta Neurochir (Wien) 149, 231–238 (2007). https://doi.org/10.1007/s00701-006-1106-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-006-1106-9