• K Nylén, M Ost, L Z Csajbok, I Nilsson, K Blennow, B Nellgård, and L Rosengren.
• Department of Neurology, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, University of Göteborg, S-413 45 Göteborg, Sweden. karin.nylen@neuro.gu.se
• J. Neurol. Sci. 2006 Jan 15;240(1-2):85-91.

ObjectivesSeveral studies have established the relevance of S-100 in blood as a marker of brain damage after traumatic brain injury. However, a more specific marker is required and glial fibrillary acidic protein (GFAP) is considered to be a good candidate.MethodsIn order to assess the increase of GFAP in serum (s-GFAP) after a severe traumatic brain injury (TBI) we collected daily serum samples from 59 patients with severe TBI starting on the day of the trauma. S-GFAP was measured using a sandwich ELISA. The Glasgow outcome scale (GOS) assessed outcome after 1 year.ResultsAll but one patient had maximal s-GFAP values above the laboratory reference value (median increased 10-fold). The highest detected levels were seen during the first days after TBI and then decreased gradually. Patients with unfavourable outcome had significantly (p<0.001) higher maximal s-GFAP values in the acute phase compared with patients with favourable outcome. All patients (n=5) with s-GFAP>15.04 microg /L died (reference level<0.15 microg/L). We found no significant difference in the maximal s-GFAP levels of patients with isolated brain injury in comparison with patients with multiple traumas.ConclusionSerum-GFAP is increased during the first days after a severe traumatic brain injury and related to clinical outcome.

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