CBS news reported this week (2/15/18)- “The first blood test to help doctors diagnose traumatic brain injury gets FDA approval.”
One purpose of this blog is to keep the public aware of the rapidly changing field of Traumatic Brain Injury (TBI). It seems as though every week there is a new development as a large amount of new resources are being devoted to this previously under-diagnosed problem. There are approximately 2 million emergency room visits to the US each year for head injury.
Many of these patients get emergency CT scans to evaluate for bleeding in the brain. Banyan Biomarkers has developed a test which can identify two brain proteins that are released into the blood after a significant head injury which may prevent the need for many CT scans. Hopefully, within the next two years this test will be commercially available in emergency rooms, athletic training facilities, and in overseas defense deployments.
This is however just the beginning for rapid screening of emergency room patients with head injuries. As previously discussed, the vast majority of these patients are discharged from the emergency room and told they are going to be fine. This includes hundreds of thousands of automobile accident victims each year, but evidence shows many will not be fine. My blog has described how many of these victims will have chronic visual problems and never be examined.
Imagine, a new technology where a simple blood test can be performed measuring brain proteins released at the time of initial injury which might help determine which head trauma patients need follow up. We are on the verge of developing such tests- today’s new test is just a beginning. Blood tests with higher sensitivity are necessary to diagnose concussion and TBI immediately with more research to follow.
Which groups of these patients will later have trouble, doctors need to know. Which car accident victims need reasonably prompt examination by neurologists and ophthalmologists to detect abnormalities? Perhaps early diagnosis will lead to brain healing drugs which will prevent the current scourge of long-term brain damage and death seen in football players, military veterans, and the general public.
CT scans are time consuming, expensive and expose patients to radiation. And the truth is they are not good at detecting brain injury unless it is severe. Inexpensive blood tests would allow inexpensive screening of patients just like cholesterol blood tests provide a risk analysis for cardiovascular disease.
As an ophthalmologist I would look forward to help from blood test evaluations on my many head injury patients. I would like to see referrals from emergency room doctors who don’t have time to perform detailed vision evaluation on every patient who has elevated levels of brain proteins in his/her blood. A large segment of the human brain (probably 50%) is used in processing visual information. If the injured brain is leaking proteins into the peripheral blood, then visual problems cannot be far behind. Technology is moving the process forward and this week’s news confirms the importance of new research.
Steven H. Rauchman, M.D. is an eye physician and surgeon who has been in private practice for 30 years. He has served as a Traumatic Brain Injury (TBI) medical/legal expert for the last 6 years specializing in the area of personal injury and related traumatic brain injuries.