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Critical Care

, 18:220

First Online: 24 April 2014


For patients presenting with acute brain injury such as traumatic brain injury, subarachnoid haemorrhage and stroke, the diagnosis and identification of intracerebral lesions and evaluation of the severity, prognosis and treatment efficacy can be challenging. The complexity and heterogeneity of lesions after brain injury are most probably responsible for this difficulty. Patients with apparently comparable brain lesions on imaging may have different neurological outcomes or responses to therapy. In recent years, plasmatic and cerebrospinal fluid biomarkers have emerged as possible tools to distinguish between the different pathophysiological processes. This review aims to summarise the plasmatic and cerebrospinal fluid biomarkers evaluated in subarachnoid haemorrhage, traumatic brain injury and stroke, and to clarify their related interests and limits for diagnosis and prognosis. For subarachnoid haemorrhage, particular interest has been focused on the biomarkers used to predict vasospasm and cerebral ischaemia. The efficacy of biomarkers in predicting the severity and outcome of traumatic brain injury has been stressed. The very early diagnostic performance of biomarkers and their ability to discriminate ischaemic from haemorrhagic stroke were studied.

AbbreviationsADMAAsymmetric dimethylarginine

AUCArea under the curve

BBBBlood–brain barrier

BNPBrain natriuretic peptide

CIConfidence interval

CSFCerebrospinal fluid

CTComputed tomography

DINDDelayed ischaemic neurological deficit

GCSGlasgow coma score

GFAPGlial fibrillary acidic protein


MMP-9Matrix metalloproteinase-9

NF-HHeavy-chain neurofilaments

NR2AbN-methyl-d-aspartic acid receptor antibody

NSENeuron-specific enolase

PENK-AProenkephalin A

SAHSubarachnoid haemorrhage

SBDPα2-spectrin breakdown product

TBITraumatic brain injury

TIATransient ischaemic attack

UCH-L1Ubiquitin C-terminal hydrolase-L-1

VEGFVascular endothelial growth factor.

Electronic supplementary materialThe online version of this article doi:10.1186-cc13841 contains supplementary material, which is available to authorized users.

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Autor: Ségolène Mrozek - Julien Dumurgier - Giuseppe Citerio - Alexandre Mebazaa - Thomas Geeraerts


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