Thomas, Piers A. W., Moffatt, Claire E., Rudd, Donna, and Marshman, Laurence A. G. (2019) S-100β in chronic subdural haematoma: prospective cohort study. Journal of Clinical Neuroscience, 67. pp. 145-150.

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Abstract

Chronic subdural haematoma (CSDH) is invariably classified as ‘neurotrauma’. However, whilst a history of trauma/fall is frequent, it is usually distant, mild or even absent. Serum S-100β > 1.38 μg/L is associated with a 100% specificity for mortality/poor outcome acutely after moderate-severe neurotrauma. Serum S-100β > 0.10 μg/L is used to screen mild neurotrauma cases for emergent neuro-imaging. Serum S-100 in controls is 0.057 μg/L. S-100β in serum or CSDH fluid (CSDHf) has not been studied. No normal ‘subdural fluid’ exists to compare CSDHf. We measured serum and CSDHf S-100β at surgical drainage in a novel prospective single-centre cohort. Of n = 86/86 (100%, M65, age 73 ± 13yrs), n = 66 (76%) reported mild trauma/fall 31 ± 23 days previously. N = 54 (63%) presented with good clinical Markwalder Grade (MG: 0–1). Paired serum and CSDHf S-100β samples were obtained in n = 45. CSDHf S-100β (n = 80) was elevated (0.9 ± 0.6 μg/L), was significantly higher than serum S-100β (n = 51) (0.33 ± 0.05 μg/L, P = 0.002), and was significantly correlated with midline-shift (r = 0.43, P = 0.005) and CSDH volume (r = 0.225, P = 0.046). CSDHf S-100β was not significantly associated with any demographic factor, co-morbidity or outcome measure.

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