Biochemical Markers in the Acute Stage of Head Injury

Abstract

In the acute stage of head injury biochemical markers are valuable in the assessment of tissue damage and outcome. In this study, in addition to evaluating computed tomographic (CT) scans, we measured plasma aldosterone and brain type of serum creatine kinase isozyme (CK-BB) to determine whether or not the values obtained reflect the degree of morphological brain changes caused by injury. All 152 patients studied were diagnosed with CT and blood samples were taken on admission. On the basis of clinical and CT findings they were classified into seven groups according to the nature and severity of the insult. Slightly over one half had severe brain injury. Aldosterone was measured by radioimmunoassay and CK-BB by electrophoresis. Aldosterone and CK-BB levels were high in patients with severe cerebral contusion and in those whose CT scan showed a marked midline shift and disappearance of the perimesencephalic cistern. Aldosterone, but not CK-BB, was markedly elevated in patients with epidural hematoma and was only moderately increased in those with a slight midline shift. The results of this study indicate that aldosterone and CK-BB may be useful as biochemical markers in the acute stage of head injury.