Open Access Emergency Medicine (Jan 2020)
The Diagnostic Value of Neuron-Specific Enolase in Children with Mild Blunt Trauma Requiring Cranial CT Scan
Abstract
Javad Mozafari, 1 Hassan Motamed, 1 Mohammad Ghasem Hanafi, 2 Bita Fatehifar 3 1Department of Emergency Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 2Department of Radiology, Ahvaz Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 3Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranCorrespondence: Hassan MotamedDepartment of Emergency Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranEmail [email protected]: The present study was conducted to investigate the relationship between serum levels of enolase and pathological findings obtained from CT scans of the brain in children with mild blunt brain trauma and help with a more accurate diagnosis of brain injuries.Methods: The present observational study was conducted on children presenting with head traumas to the emergency department (ED) of Golestan Hospital in Ahvaz, Iran in 2016. A venous blood sample was immediately taken by the ward nurse from all the eligible patients within 6 hrs of the incident after obtaining their information, performing initial examinations and their initial stabilization. Laboratory serum levels and the corresponding interpretations of CT scans of the brain were collected, recorded and then evaluated and analyzed.Results: A total of 62 children with mild blunt brain trauma were included in the study. A significant difference was observed between the positive CT scan group (2.7± 9.74 μg/L) and the negative group (4.23± 1.33 μg/L) in terms of serum levels of enolase (P< 0.0001). The area under the receiver operating characteristic (ROC) curve was 0.992 for serum levels of enolase in diagnosing brain lesions caused by mild head traumas. Moreover, with a cut-off point of 6.97 μg/L, brain lesions could be detected with a sensitivity of 93.55% and a specificity of 100%.Conclusion: Serum levels of enolase were found to be higher in patients with brain injuries. This highly accurate diagnostic biomarker can be recommended for estimating the presence of brain lesions associated with mild head traumas in infants.Keywords: head trauma, blunt trauma, diagnosis, neuron-specific enolase, children