Abstract
Previous studies have suggested the usefulness of the postmortem serum S100B level as a marker of the severity of brain damage. In this study, we investigated the S100B level in the cerebrospinal fluid (CSF) in serial autopsy cases ( n = 216, within 3 days postmortem), including those of blunt injury ( n = 34: fatal head injury, n = 20; others, n = 14), sharp instrument injury ( n = 9), mechanical asphyxiation ( n = 19), drowning ( n = 11), fire fatality ( n = 26), intoxication ( n = 20), hypothermia (cold exposure, n = 16), hyperthermia (heat stroke, n = 9), acute cardiac death ( n = 52) and pneumonia ( n = 20). The CSF S100B level showed a moderate postmortem time-dependent increase for acute cardiac death ( r = 0.58, p < 0.0001) and asphyxia ( r = 0.741, p < 0.001). In cases of survival time within 48 h, drowning and hypothermia usually showed a lower CSF S100B level (around 500 ng/ml), and the level was higher for delayed head injury death, asphyxia, intoxication, and hyperthermia (around 1500 ng/ml) ( p < 0.05). In fatal head injury cases, however, CSF S100B did not correlate with the survival time or postmortem interval. A CSF S100B level of >2000 ng/ml in the early postmortem period might be considered a biochemical sign of fatally severe brain damage.
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