Specialized Testing For Traumatic Brain Injury

There are more than 1 million emergency visits annually for traumatic brain injury in the United States. The majority of these visits are for mild injuries, primarily the result of falls and motor vehicle crashes. The challenge for doctors is to identify which of these patients has an acute traumatic brain injury, something that is not always immediately evident and which often leaves patients, who are observed and sent home, undiagnosed. A blood test that can help predict the seriousness of a head injury and detect the status of the brain/blood has now made recent strides of acceptance, according to research at the Rochester Medical Center. According to their findings, widespread use of the blood test could result in a 30 percent reduction of CT scans.

Although CT scan is still the most favored method currently being used for the screening of head injuries, it does determine the amount of bleeding in the brain but it does not detect more subtle injuries to the brain’s neurons, which can result in lasting neurological defects. In fact, 95 percent of CT scans look normal for patients with a relatively mild but potentially life altering injury, said Doctor Jeffrey Bazarian, M.D., M.P.H., associate professor of Emergency Medicine, Neurology, and Neurosurgery at URMC.

Dr. Bazarian suggests that recent news stories about tragic head injuries—from the death of actress Natasha Richardson to the brain-injured Iraq war soldiers and young athletes—underscore the need for a simpler, faster, accurate screening tool for those suffering from traumatic brain injuries.

The S-100B blood test was recently determined to relay critical information about how the blood/brain barrier (BBB) is functioning after a head injury so it can be a useful tool for patients with mild injuries. Previous studies have shown the S-100B serum protein biomarker increases rapidly after an injury. If measured within four hours of the injury, the S-100B test accurately predicts which head injury patients will have a traumatic abnormality such as hemorrhage or skull fracture on a head CT scan. It takes about 20 minutes to get results and could spare many patients unnecessary radiation exposure.

In a recent interview with Science Daily, Bazarian said, “the S-100B blood test is an important part of the tool set we need to improve our treatment of patients with brain injuries. It’s not the ultimate diagnostic test, but it may make things easier for patients, and it will help doctors sort through difficult clinical decisions.”

Before the S-100B blood test, the best way to know if the BBB was open was to perform an invasive procedure called a ventriculostomy. During a ventriculostomy, doctors insert a catheter through the skull and into the brain, withdraw fluid, and compare the concentration of albumin protein in the cerebrospinal fluid to the concentration in the blood.

However, a study found that serum S-100B concentrations could accurately predict the function of the blood/brain barrier 12 hours after injury, eliminating the need for the invasive procedure. Physicians at six emergency departments in upstate New York will continue to study the accuracy of the test among 1,500 patients this year. The test is used routinely in 16 European countries as a screening device.

Dealing with a traumatic brain injury is not something you should have to do by yourself. There are elements to this process that are crucial to the success of your treatment. The first thing to do is to make sure that you are receiving the best specialized test and are being seen by specialized doctors. A personal injury attorney who specializes in traumatic brain injuries is also a helpful and often times a necessary part of these relationships. If you have suffered a traumatic brain injury, take the first steps to ensure that you receive the care you need, and contact a lawyer who can guide you to the specialists and treatment you need and who can make sure that the right person pays for that treatment. At Fisher Stark Cash, we have experience with traumatic brain injuries and are eager to see our clients properly diagnosed and set on the path to recovery. If you have been diagnosed with or suspect that you or a loved one has experienced a traumatic brain injury, call our office at (828) 505-4300 to see how we can help.

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