This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Traumatic brain injury (TBI) kills and disables more children each year than any other cause (Duhaime and Raghupathi 1999) and is the leading cause of long-term disability in children and young adults (National Institutes of Health, 1999). Despite the fact that it is a pressing health issue, our understanding of the pathomechanistic events associated with acute brain injury in humans remains quite limited, and there are no proven therapies for children or adults in this clinical setting. This study in children suffering TBI is designed to characterize the association between the concentrations of selected blood and spinal fluid biomarkers and advanced neuro-monitoring parameters with patient outcome. Based on that analysis, potentially useful biomarkers and neuro-monitoring parameters may be identified. The latter will have several important clinical applications: it may allow us 1) to stratify patients by the severity of their TBI; 2) to better monitor the progression of brain injury-induced pathology and recovery; 3) to guide therapy; 4) to monitor the effects of therapy/intervention; and 5) to predict outcome more accurately after traumatic brain injury in children. Accurate patient stratification and valid methods of predicting outcome are vital to the subsequent conduct of clinical trials in this patient population.
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