Biomarkers of acute brain injury.

PURPOSE OF THE REVIEW: Acute brain injuries are the leading cause of morbidity and disability worldwide. Lately, we have observed significant advances in neuroimaging, which have resulted in improved radiological diagnostics; however, laboratory biomarkers of central nervous system (CNS) injury are still not part of routine workup.

RECENT FINDINGS: Numerous studies proposed potential acute brain injury biomarker candidates. New data extend the use of well-known CNS-derived proteins and enzymes to acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage patients. The growing interest in microRNA (miRNA) profiling brings encouraging results for its possible utility as a biomarker of CNS injury in clinical practice. New data are also reported in the area of inflammatory markers - both well-studied and new proposed agents, such as growth differentiation factor 15, demonstrate promising perspectives to be used in prognostication following traumatic brain injury. More researchers propose combined biomarker test panels including proteins, miRNA, and inflammatory parameters, to increase the sensitivity and specificity of assessments.

SUMMARY: This review aimed to present recent findings on acute brain injury biomarkers that could be implemented in the management of neurocritical patients. Researchers report data on new potential CNS injury biomarker candidates that must still be validated and standardized in large randomized trials.