Published online Feb 26, 2017. doi: 10.4331/wjbc.v8.i1.21
Peer-review started: September 1, 2016
First decision: September 29, 2016
Revised: October 23, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: February 26, 2017
Processing time: 180 Days and 14.5 Hours
Brain metabolism is an energy intensive phenomenon involving a wide spectrum of chemical intermediaries. Various injury states have a detrimental effect on the biochemical processes involved in the homeostatic and electrophysiological properties of the brain. The biochemical markers of brain injury are a recent addition in the armamentarium of neuro-clinicians and are being increasingly used in the routine management of neuro-pathological entities such as traumatic brain injury, stroke, subarachnoid haemorrhage and intracranial space occupying lesions. These markers are increasingly being used in assessing severity as well as in predicting the prognostic course of neuro-pathological lesions. S-100 protein, neuron specific enolase, creatinine phosphokinase isoenzyme BB and myelin basic protein are some of the biochemical markers which have been proven to have prognostic and clinical value in the brain injury. While S-100, glial fibrillary acidic protein and ubiquitin C terminal hydrolase are early biomarkers of neuronal injury and have the potential to aid in clinical decision-making in the initial management of patients presenting with an acute neuronal crisis, the other biomarkers are of value in predicting long-term complications and prognosis in such patients. In recent times cerebral microdialysis has established itself as a novel way of monitoring brain tissue biochemical metabolites such as glucose, lactate, pyruvate, glutamate and glycerol while small non-coding RNAs have presented themselves as potential markers of brain injury for future.
Core tip: The biochemical markers of brain injury are being increasingly used to assess the severity and prognosis in the injured brain. While S-100, glial fibrillary acidic protein and ubiquitin C terminal hydrolase have been used as early biomarkers to aid in clinical decision-making and initial management, other biomarkers help in long-term prognosis. Cerebral microdialysis is a novel way of monitoring brain tissue biochemical metabolites and each component gives an idea about the severity and type of pathologic process in the brain. In addition, small non-coding RNAs have presented themselves as potential markers of brain injury for future research.