Study on the content changes and significance of neuron-specific enolase in serum and cerebrospinal fluid in patients with diffuse axonal injury

Objective: To investigate the changes of neuron specific enolase (NSE) in serum and cerebrospinal fluid(CSF) in patients with diffuse axonal injury (DAI) and its relationship with injury severity and prognosis. Methods: The NSE level in serum and CSF was detected by radioimmunoassay in 79 patients with DAI (experimental group) and 30 patients without nervous system disease (control group) respectively. According to the GCS scores on admission, the patients in experimental group were divided into minor in- jury group(n = 23), moderate injury group(n = 27) and severe injury group(n = 29). The serum and CSF samples were collected at within 24 hours, 2-3, 7 and 14 days after head injury. The relationships between the NSE level and both the severity of DAI and prognosis were analyzed. Results: Within 24 hours after head trauma, the level of NSE was significantly higher in the patients with DAI than that in the control group (P < 0.01). It reached maximum within 2-3 days, and decreased within 7-14 days. The level of NSE increased higher in the severe injury group than in the minor or mild injury group (P < 0.01). The level of NSE was markedly higher in the patients with poor prognoses than good ones (P < 0.01 or P < 0.05). Persisting high NSE value was found in dying patients. Conclusion: The level of NSE in serum and CSF in patients with DAI may reflect the degree of brain damage. Furthermore, it may prove to be an index of monitor and prognostication in patients with DAI. (authors)