Evaluation of the Role of Biomarkers in Diagnostics and Prognostication of Head Injuries. Summary of the Doctoral Thesis

Abstract

Head trauma is one of the most common causes of death and disability throughout the world, and it causes serious social and economic problems. The proportions of severity of head trauma are as follows: approximately 88% is light head trauma, 7% - medium severe head trauma, and 5% severe and fatal head injuries, which are followed by permanent disability in children. It has been proven that the most unpredictable are the light head injuries, which on the initial evaluation show 13 – 15 points of GCS, later after the trauma moment they can cause intracranial bleeding, diffuse axonal damage, and that is the reason why it is very important to make precise diagnosis in the acute stage and also give prognosis about the end result in the group of patients with this kind of trauma. This brings focus on biomarkers as the prognostic indicators in patients with head injuries. The aim of the study was to investigate the biomarkers characteristic to the secondary injury, their expression in the brain tissue samples and in peripheral blood samples in different time points after the injury. The morphology chapter included 28 patients of different age after fatal head injuries. The patients were divided in several groups: children and adults. Each of those groups were sub-divided further – those, who died on the spot of the injury, and those who died after a period of time. In all patients cytoskeletal protein GFAP, filaments NF, cytokines IL-6 and IL-10 expression in the brain tissue, apoptotic cell count and distribution in the brain tissue in the spot of the injury and counterstroke were analyzed. The clinical chapter included 18 patients with severe, medium severe and light head injuries up to 7 years of age. In these patients of 10 inflammatory biomarkers were measured in four defined time points (24, 48, 72 and 96 hours after the trauma).