Is a hard blow to the head a reason for medical inquiry? The difference between a minor injury and a concussion, which can have long lasting repercussion on memory and cognition, is very subtle. Doctors rely on studying the patients' symptoms to determine if a concussion, more or less severe, occurred. It can take days, even a week, before an accurate diagnosis can be made. This delay in treatment means some patients might have a hell of a week. A simple blood test can diagnose a concussion within a couple of hours from the injury, according to preliminary results. In the worlds of sports, these news might be a godsend as every day lost to recovery is precious.
Following a brain injury, two proteins called GFAP and UCH-L1 are released into the bloodstream and can serve a concussion biomarkers. Dr. Linda Papa, an Orlando Health emergency medicine specialist and colleagues tested nearly 600 adults treated at Orlando Regional Medical Center. Half came to the hospital after they suffered concussions following car crashes, falls, sports and other activities. The other half came for non-brain trauma related injuries, like broken bones.
Blood samples were taken hours from the injury, then periodically over the course of one week. Both protein levels in the blood were much higher in concussions patients. Low levels were also found in some non-concussion patients, likely because of a head bump suffered during the accident. The UCH protein levels rapidly rose following the concussion-causing injury, but fell just as fast after two days. GFAP levels, however, remained detectable for a whole week after injury.
“We have so many diagnostic blood tests for different parts of the body, like the heart, liver and kidneys, but there’s never been a reliable blood test to identify trauma in the brain,” Papa said. “We think this particular test could change that.”
Dr. Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke, said the findings are "the holy grail for head injury". Some 2 million Americans suffer concussions each year. Most are mild causing patients to temporarily experience loss of consciousness, amnesia or feeling disoriented. Repeated brain trauma, however, is a different story and can cause permanent damage as evidenced by degenerative brain diseases found in some retired NFL players.
For athletes, this sort of blood test might prove extremely useful leading to faster and more reliable treatment. Dehydration, for instance, can cause concussion-like symptoms and health professional can find it difficult to make the right diagnosis since an NFL player can be equally at risk of being dehydrated or suffering from brain trauma.
The findings published in JAMA Neurology are preliminary and might be a couple of years before this sort of test can be used at large.