Usefulness of S100β protein for managing minor head trauma in the emergency service

Flore Tuyumbu MD (1), Andréa Penaloza MD, PhD (2), Said Hachimi-Idrissi MD, PhD (3) Published in the journal : June 2018 Category : Emergency

Summary :

Over the last decades, the use of biomarkers in emergency medicine has considerably increased. While the P S100β protein has been considered as a neurological prognostic factor following cardiac arrest or stroke occurrence, it is principally in the minor head trauma management that the P S100β seems to be of interest. Studies have highlighted its usefulness for excluding neurological lesions, without performing brain computed tomography (CT), and this, with a good sensitivity close to 100% (CI: 50 to 100%). The P S100β analysis could be particularly helpful for clinicians in cases where the patient's neurological examination proves unreliable.

Key Words

S100β, emergency service, head trauma, shock, cardiac arrest, diagnostic and prognostic strategy

What is already known about the topic?

The management of minor head trauma (MHT) constitutes a daily concern in emergency services. Given the small number of patients with intracranial complications secondary to MHT, as well as the potential risk related to irradiation, particularly in young patients, performing a cerebral tomography in patients with a normal clinical examination is questionable. The emergency physician would like to be able to identify those patients at very low risk of complications, and it is in this perspective that several studies have been carried out with the S100β protein.

What does this article bring up for us?

Patients with head traumas are a daily occurrence in the emergency room, and the uncertainty of the clinician as to whether he/she should perform cerebral tomography in patients with minor head trauma and normal clinical examination represents a daily issue. Several articles concerning the use of P S100β in this patient category have been published in recent years, with good results as regards sensitivity. The use of a biomarker such as the S100β protein seems to be of interest in emergency services, enabling clinicians to better identify patients at low risk of complications after minor head trauma, in whom tomography could thus be avoided. This article reviews these various studies in order to better assess the role of the S100β protein assay in emergency services.