Biomarkers; Role in Brain Injury Diagnosis

Abstract

The knowledge of the pathophysiology of traumatic head injury is necessary for adequate and patient-oriented treatment. As the primary insult, which represents the direct mechanical damage, fully treatedinfluenced, target of the treatment is the limitation of the secondary damage. It is influenced by changes in cerebral blood flow, impairment of cerebrovascular autoregulation, cerebral metabolic dysfunction and inadequate cerebral oxygenation. Furthermore, excitotoxic cell damage and inflammation may lead to apoptotic and necrotic cell death. Understanding the multidimensional cascade of secondary brain injury offers differentiated therapeutic options. Serial clinical examination is not possible in poor-grade patients, so the interest in invasive and non-invasive brain monitoring techniques, including measurements of cerebral perfusion and ICP, venous oximetry (jugular bulb catheters), brain tissue oxygen tension (PbtO2), microdialysis, continuous electroencephalography (EEG), and trans-cranial dopplex (TCD) are used .Results are best interpreted when assessed using multimodality brain monitoring protocols. Biomarkers would have important applications in