Journal of the Neurological Sciences 170 (1999) 32–35 www.elsevier.com / locate / jns Elevated S100 blood level as an early indicator of intraventricular hemorrhage in preterm infants: Correlation with cerebral Doppler velocimetry a b a b a Diego Gazzolo , Paola Vinesi , Marco Bartocci , Maria Concetta Geloso , Wanda Bonacci , a c b, * Giovanni Serra , Kenneth G. Haglid , Fabrizio Michetti a Department of Neonatology, Giannina Gaslini Children’ s Hospital, I-16147 Genoa, Italy b Institute of Histology, Catholic University, I-00168 Rome, Italy c Department of Anatomy and Cell Biology, Goteborg University, S-413-90 Goteborg, Sweden Received 19 February 1999; received in revised form 3 August 1999; accepted 9 August 1999 Abstract The aim of this study was to assess the use of S100 protein in blood as a means of identifying preterm infants at risk of intraventricular hemorrhage. In 25 preterm newborns, S100 blood concentrations were measured by an immunoradiometric assay during the first 48 h. Cerebral Doppler velocimetry waveform patterns were also tested at the time the blood sample was taken, when clinical and cerebral ultrasound scanning were still normal. Of the 25 newborns studied, 14 were controls and 11 developed intraventricular hemorrhage as revealed by ultrasound scanning more than 72 h after birth, and clinically confirmed by neurological examination on the seventh day of follow-up. S100 blood concentrations were significantly higher ( P , 0.002) in infants with intraventricular hemorrhage than in control infants and also correlated significantly ( r 5 0.81, P , 0.003) with the grade of hemorrhage. A significant correlation ( r 5 0.70, P , 0.05) between the S100 blood concentration and the middle cerebral artery pulsatility index was also observed. The present data show that S100 blood concentrations offer a measurable parameter of brain lesion in preterm infants before a radiological assessment of hemorrhage can be performed, when clinical symptoms may be silent and preventive / therapeutic action could be especially useful.  1999 Elsevier Science B.V. All rights reserved. Keywords: S100 protein; Intraventricular hemorrhage; Preterm infants; Hemodynamic impairment; Brain distress; Biochemical marker; Blood protein 1. Introduction when ultrasound scanning and radiological procedures are unable to detect bleeding is important. Furthermore, Perinatal asphyxia is known to constitute a risk in quantification of the extent of the hemorrhagic lesion is preterm infants, possibly leading to germinal matrix or important to permit the prevention and / or treatment of intraventricular hemorrhage (IVH), which is currently clinical neurological damage. difficult to diagnose during the first 72 h [1], despite The concentration in biological fluids of the S100 accurate postnatal monitoring. The availability of quantita- protein, which is a member of the calcium-binding proteins tive parameters indicating subclinical lesions at a time present primarily in nervous tissue [2,3], represents a well established biochemical index of brain damage [4–6]. Recently, it has also been shown to be a reliable tool to ` *Corresponding author. Institute of Histology, Universita Cattolica del monitor brain distress in child patients [7]. S. Cuore, Largo Francesco Vito, 1, I-00168 Rome, Italy. Tel.: 139-06- The present study investigated whether S100 protein is a 301-54463; fax: 139-06-305-1343. E-mail address: fabrizio.michetti@rm.unicatt.it (F. Michetti) useful means of evaluating perinatal brain distress, which 0022-510X / 99 / $ – see front matter  1999 Elsevier Science B.V. All rights reserved. PII: S0022-510X(99)00194-X