Cerebrospinal Fluid Endostatin/Collagen XVIII Concentrations in Patients With Severe Traumatic Brain Injury
Condition: Traumatic Brain Injury
MeSH terms: Brain Injuries; Brain Injuries, Traumatic; Wounds and Injuries
Study type: Observational [Patient Registry]

Summary: 
      Angiogenesis is an important pathophysiological response to traumatic brain injury (TBI) and
      modulated by pro- and anti-angiogenic factors. Recent studies have suggested that endogenous
      angiogenesis inhibitor endostatin/collagen XVIII might play an important role in the
      secondary brain injury following TBI. The aim of this study was to investigate early changes
      in the concentrations of CSF endostatin/collagen XVIII after TBI and evaluated the relations
      of endostatin/collagen XVIII to injury severity and clinical outcome. Endostatin/collagen
      XVIII concentrations were measured serially for 1 week after hospitalization by using the
      enzyme linked immunosorbent assay method in the cerebrospinal fluid of 30 patients with TBI
      and a Glasgow Coma Scale score of 8 or less on admission. Comparative analysis were used to
      determine if its serial changes correlate with the GCS score and prognosis. Receiver
      operating characteristic curve was used to appraise the value of CSF endostatin/collagen
      XVIII levels in predicting the prognosis of patients with severe head injury.
    

Detailed description: 
      Patients with severe TBI (Glasgow Coma Scale score of 8 or less) requiring continuous lumbar
      drainage of CSF were included in the study. Patients delivered within 4 h whose highest
      abbreviated injury score was 3 or less (other than head injury) were considered to be
      isolated TBI cases and were included. To avoid interfering factors, patients who suffered
      open or combined injuries, had existing prior neurological disease were excluded. Those who
      died within the first week of hospitalization and/or whose serial cerebrospinal fluid samples
      could not be obtained were also excluded as having incomplete data. Accordingly, 30 patients
      were analyzed in this study. Demographic data, including age, gender, mechanism of trauma and
      GCS score at admission were documented when the patients arrived at the emergency room. The
      control group comprised 20 patients whose cerebrospinal fluid was examined via lumbar
      puncture for investigation of suspected neurological disease. All patients had normal
      neurological examination, negative imaging studies, and none had evidence of trauma or
      preexisting neurological disease, including tumors, vascular anomalies, or abnormalities of
      cerebrospinal fluid. The study had approval from the hospital ethics committee and informed
      consent for participating in the study was obtained from an appropriate member of each
      patient's family before performance of lumbar drainage.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Of the 30 patients with severe TBI, twenty were male and ten were female. The patients' age
        ranged from 16 to 82 years, with mean age of 51.1 years. The mechanisms of trauma included
        motor vehicle collisions, falls, heavy strikes (patients who were hit by heavy objects such
        as bricks, sticks, or falling objects) and assaults. Types of lesions, as evidenced by
        radiologic and neurologic symptoms or signs, included cerebral contusions/lacerations,
        intracranial hematomas, brain stem injury and diffuse axonal injury.
      
Biospecimen description: 
      Cerebrospinal fluid
    
Keywords: Traumatic brain injury;; Endostatin/collagen XVIII;; Cerebrospinal fluid;; Prognosis