Biomarker S100B Can Help Rule Out Hemorrhage After Minor Head Injury

Dr. Heinrich Thaler Trauma Hospital Meidling Vienna Interview with:
Dr. Heinrich Thaler
Trauma Hospital Meidling
Vienna Austria

Medical Research: What is the background for this study?

Dr. Thaler:  An increased prevalence of minor head injuries in elderly patients combined with the frequent use of platelet aggregation inhibitors resulted in increased hospital admissions and cranial computed tomography. We undertook the study with the aim to reduce the workload of medical staff and costs as well as the radiation burden in the management of patients with mild head injuries.

Medical Research: What are the main findings?

Dr. Thaler:  S 100B is a reliable negative predictor in elderly patients and/or in patients on platelet aggregation inhibitors to rule out an intracranial hemorrhage after minor head injury (S100B is an astroglial derived protein detectable in serum in the case of cerebral tissue damage). The negative predictive value of S100B is 99,6%. We conclude that S100B levels below 0.105 µg/L can accurately predict a normal cranial computed tomography after minor head injury in older patients and those on antiplatelet medication. Additionally we found no increased risk for intracranial hemorrhage in older patients or in patients receiving antiplatelet therapy.

Medical Research: What should clinicians and patients take away from your report?

Dr. Thaler:  Using S100B physicians can safely reduce the number of admissions and cranial computed tomography in older patients with minor head injuries and in patients with minor head injuries receiving platelet aggregation inhibitors.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Thaler:  We only evaluated platelet aggregation inhibitors (low dose aspirin, clopidogrel) in this patient group. However, the direct oral anticoagulants (DOACs) are yet to be evaluated.


Evaluation of S100B in the diagnosis of suspected intracranial hemorrhage after minor head injury in patients who are receiving platelet aggregation inhibitors and in patients 65 years of age and older

Thaler HW1, Schmidsfeld J2, Pusch M1, Pienaar S1, Wunderer J1, Pittermann P1, Valenta R3, Gleiss A4, Fialka C1, Mousavi M2.

J Neurosurg. 2015 Jul 7:1-7. [Epub ahead of print]


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