TeachableMedicalNews article 05292023

Teachable moment in classrooms:

  1. cellular basis of life chapter – intermediate filaments are part of the cytoskeleton
  2. nervous system chapter – neurons and astrocytes are cells of the nervous system
  3. brain chapter – meninges are protective coverings of the central nervous system
  4. cardiovascular system chapter – reabsorption during capillary exchange brings degraded proteins into blood circulation
  5. brain chapter – cerebrospinal fluid is absorbed into venous sinus

The news item:  Recently the following report appeared online:

https://www.nbc12.com/prnewswire/2023/03/07/abbott-receives-fda-clearance-first-commercially-available-lab-based-blood-test-help-evaluate-concussion/?outputType=amp

The article states that a new blood test is available for patients who are suspected to have suffered concussion because of an impact injury, and that this test may help to find the patients who might need a CT scan for further evaluation. The test works by analyzing two biomarkers.

So, Why Do I Care??  Concussion happens frequently with over 2 million concussions occurring yearly in the USA. Whether it is from a car accident, from a fall, or from a collision at a sporting event, the consequence is impaired brain function. That comes with a price tag of over $40 billion per year medical cost and lost income in the USA.

Plain English, Please!!! First, let’s talk about what concussion is. An injury to the brain from a physical impact is called concussion. The symptoms can be a brief loss of consciousness followed by headache, memory impairment, loss of orientation, loss of cognitive functions, depression. The most dangerous aspects of concussion are the long-lasting effects.

Second, let’s talk about how the brain is injured by mechanical forces. While it is true that the meninges, the membrane-like covering of the brain, provide a moderate level of protection against sudden movement of the brain, but strong physical forces do move the brain inside the skull, and cells on the surface gyruses are squished, and cells deeper in the brain are stretched or pulled apart.  The compression and the displacement of the cells cause injury to the cell membrane, the cytoplasm of the cells leaks out, and the cells can no longer function normally, so neurons misfire, and the supporting glial cells malfunction.

Third, let’s talk about the biomarkers of the blood test. Because the damaged cells release their internal components into the blood, or into the cerebrospinal fluid (which is absorbed into blood), those components become markers of the injury. The test looks for two of those biomarkers in the blood. One is called glial fibrillary acidic protein which comes from the damaged cytoskeleton of astrocytes. The other is called ubiquitin C-terminal hydrolase L1 which is a protein inside the neurons. Clinical studies have shown that when the amount of those biomarkers increase in blood after concussion, there is a high likelihood of more severe consequences to the injury. Therefore, the high level of biomarkers indicates the need for a CT (computerized tomography) scan to carry out a more detailed evaluation of the people who suffered concussion.

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