Introduction

The annual incidence rates of hospital-admitted head injuries vary between 90 and 400/100 000 population in different Western countries [1]. Most of the patients with head injuries are fully conscious when evaluated. The management of such minor head injuries (MHI) is focused on the early detection of patients who deteriorate due to a post-traumatic intracranial haematoma. Expensive screening methods such as hospital admission for overnight observation or computed tomographic (CT) scanning are used to detect the relatively few individuals who develop this life-threatening complication [2]. After the injury, many patients experience postconcussion symptoms, even after uneventful recoveries in the acute stage.

In most western countries, injuries are the leading cause of death among individuals under 45 years of age [1]. Traumatic brain injury (TBI) accounts for one-half of the deaths and most cases of permanent disability after injury. Accurate evaluation of the primary injury and prevention of secondary ischaemic injury is essential in the clinical management. TBI is, however, difficult to assess. Clinical examination is of limited value in the first hours and days after a severe head injury (SHI). Most of the diagnostic process is based on modern neuroimaging techniques, such as CT or magnetic resonance imaging (MRI), but CT has a relatively low sensitivity for diffuse brain damage and the availability of MRI is limited.

A biochemical marker in the serum with the ability to both detect intracranial pathology and to predict postconcussion symptoms would be highly desirable in the management of MHI.