Test for Infant Traumatic Brain Injury

A blood or spinal fluid test may be the latest weapon in diagnosing traumatic brain injury in infants with vague, nonspecific symptoms, such as vomiting or fussiness, according to a recent study published in the journal Pediatrics.

The study looked to see if the proteins NSE and MBP could be useful for screening well-appearing infants who present without a history of trauma and with nonspecific symptoms. A previous study determined the two bio-markers were elevated in patients with inflicted traumatic brain injury who presented with a history of trauma or with severe symptoms.

The investigation included 98 infants less than one year old presenting to the Children's Hospital of Pittsburgh emergency department with one of the following symptoms: apparent life-threatening event, vomiting at least four times without diarrhea in the past 24 hours, seizures, or nonspecific neurologic signs or symptoms.

After measuring the NSE and MBP levels in the blood and/or cerebrospinal fluid, those infants not indentifed as having an inflicted traumatic brain injury were tracked to one year of age to identify evidence of possible child abuse.

The investigators are seeking further study of the potential value of determining levels of these two proteins in cases of suspected abuse involving inflicted traumatic brain injury in infants.

Writing in the journal, the researchers said if their study was confirmed it "would allow health care providers to limit medical complications as a result of delayed diagnosis, minimize re-injury to infants by preventing them from returning to an unsafe environment, and protect siblings who may be living in the same violent environment" and at risk of traumatic brain injury.

See also:
Journal of Neurology, Neurosurgery and Psychiatry
Blood and cerebrospinal fluid markers of brain injury

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