Brain Damage

An April 20 research article out of the University of California, Irvine in collaboration with other major universities has identified a panel of 6 plasma blood test markers to help diagnose acute concussion. One purpose of this blog is to provide up-to-date scientific information on traumatic brain injury (TBI), to the general public in a manner that is easily understood.

In the research article, 6 college athletes were identified- 3 with acute concussion, and three without head injury. Blood was drawn within six hours of injury. The published study was able to identify six biomarkers that were present in concussion patients and not present in non-concussion athletes. The rapid detection by blood test is needed to diagnose potential TBI, especially mild TBI. I have discussed in a previous blog the approval by the FDA of one such blood test.

It is understood that injured brain tissue releases chemicals into the blood stream almost immediately after impact. The medical community is working hard to identify relatively inexpensive rapid blood tests to make the diagnosis. This study is far from conclusive, but the direction of such investigation is noteworthy. Over the last two years, there has been an acceleration in this type of clinical research. Other concussion tests are good but may not provide prognostic information.

If you know individuals who have a spike in measurable blood values, this spike can be measured over the first few days or weeks after injury. Perhaps, in patients where there is a rapid drop in these blood values, there is a better prognosis. However, if blood measurements remain elevated there might be long-term difficulties even in people who seem to recover.

That’s one critical question facing TBI management and treatment- if medicine doesn’t have the financial resources to follow every person after a concussion, it may need to carefully select out those at risk. The test needs to identify abnormal immediately- health care professionals usually get only one shot in making the correct diagnosis- that is when the individual immediately seeks care after the head trauma. After the first visit, the patients usually never return to the doctor.

I believe a combination of blood tests which are easy to do (not like getting a very expensive and more invasive MRI scan) is the path that needs to be followed. Patients in the emergency room frequently get routine blood tests after an injury. If we could add TBI blood tests into the mix, that would make life simpler. All sorts of short and long-term data could then be established.

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.

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