Evaluation of brain injury biomarkers in mild traumatic brain injury with and without computed tomography findings

AIM: Mild traumatic brain injury (mTBI) presents diagnostic challenges, with head computed tomography (head CT) often overutilized in emergency settings. Blood biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have shown promise in early injury detection. Aim of this study was to evaluate the diagnostic utility of GFAP and UCH-L1 in identifying intracranial injuries early and potential reduction in unnecessary head CT scans in mTBI patients. METHODS: A prospective study was conducted on 102 adult patients with mTBI. Serum levels of GFAP and UCH-L1 were measured within 12 hours post-injury and compared with head CT findings using appropriate statistical analyses. RESULTS: Both biomarkers demonstrated 100% sensitivity and moderate specificity, with high negative predictive value (NPV), supporting their utility in ruling out injuries detectable on CT. CONCLUSION: GFAP and UCH-L1 are effective early biomarkers for excluding significant intracranial injuries and may help optimize head CT scan utilization in the acute management of mTBI.