***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Elevated serum neuron-specific enolase  levels are correlated with brain cell damage . Low scores according to Glasgow Coma Scale are also considered as serious poor prognostic factor . The aims of the study were to investigate whether there is a correlation between the two measurements in patients with traumatic brain injury and whether serum neuron-specific enolase levels have potential as a screening test to predict outcome . A total of 169 consecutive patients with traumatic brain injury admitted to our clinic between 2002 and 2005 are included in this study . Those patients , who had any major health problem before trauma , were excluded from the study . However , patients with isolated head injury were included in the study . Serial serum neuron-specific enolase concentrations taken at the first 2 , 24 , and 48 h after traumatic brain injury were analyzed . A computed tomography was performed on each patient on admission . Their Glasgow Coma Scale scores were recorded serially . The relationship between Glasgow Coma Scale scores and the serum neuron-specific enolase levels were assessed by statistical methods . There was a significant negative correlation between the serum neuron-specific enolase levels and Glasgow Coma Scale scores . The levels of neuron-specific enolase were significantly higher in the patients who died in 30 days after trauma and whose scores were lower than or equal to 8 points in Glasgow Coma Scale . Although there are several serious limitations of the use of neuron-specific enolase as a biomarker in traumatic brain injury ( i.e. , hypoperfusion , extracranial trauma , bleeding , liver , or kidney damage also increase the level of neuron-specific enolase ) , its concentrations may be useful as a practical and helpful screening test to identify neurotrauma patients who are at increased risk and may provide supplementary estimation with radiological and clinical findings In recent years , in addition to neurological examination and neuroradiologic examinations , attempts have been made to assess the severity of post-traumatic brain injury and to obtain an early idea of patient prognosis using biochemical markers with a high degree of brain tissue specificity . One such enzyme is neuron-specific enolase ( NSE ) . This study investigates the correlation between serum NSE levels , Glasgow Coma Score , and prognosis measured by Glasgow Outcome Scores in head trauma patients . This was a prospect i ve study conducted with 80 trauma patients presenting to the Emergency Department . Patients were divided into four groups . The first group consisted of patients with general body trauma , but no head trauma . The second group had minor head trauma .  The third group had moderate head trauma  , and the fourth group had severe head trauma .  The relationship between subjects ' admission NSE levels and admission and discharge Glasgow Coma Scores ( GCS ) and Glasgow Outcome Scores ( GOS ) 1 month later was examined . A receiver operating characteristic ( ROC ) analysis was performed using a serum NSE cutoff level of 20.52 ng/mL and a GOS of 3 or less as the definition of poor neurologic outcome . There was a significant difference in the NSE levels between group 1 ( general trauma ) and group 3 ( moderate head trauma ) . There was also a statistically significant difference in NSE levels between group 1 ( general trauma ) and group 4 ( severe head trauma ) ( p < 0.05 ) . There was a statistically significant inverse relationship between NSE levels and GOS as determined within groups 3 ( moderate ) and 4 ( severe head trauma ) ( p < 0.05 ) . When NSE levels were compared with admission GCS , it was found that GCS fell as NSE levels rose . There was no significant correlation between NSE and GCS within groups 3 ( moderate ) or 4 ( severe ) . There was a statistically significant correlation within group 2 ( mild ) ( p < 0.05 ) . By ROC analysis , serum NSE  was 87 % sensitive and 82.1 % specific in predicting poor neurologic outcome in the study patients . The area under the curve was 0.931 . This study shows that initial serum NSE levels in moderate and severe head trauma patients correlate inversely with GOS 1 month later , but only within the moderate and severe head trauma groups . However , serum NSE  was 87 % sensitive and 82.1 % specific in predicting poor neurologic outcome in all of the study patients . This derived cutoff value now needs to be prospect ively vali date BACKGROUND AND PURPOSE Reduction in infa rct volume is the st and ard measure of therapeutic success in animal stroke models . Reduction in infa rct volume has been advocated as a biological surrogate or auxiliary outcome measure for human stroke clinical trials to replace or supplement deficit , disability , and global clinical scales . However , few studies have investigated correlations between infa rct volume and clinical end points in acute ischemic stroke patients . METHODS CT scans at days 6 to 11 were acquired prospect ively in 191 fully eligible patients enrolled in the R and omized Trial of Tirilazad Mesylate in Patients With Acute Stroke ( RANTTAS ) . Patients were enrolled within 6 hours of onset of stroke in any vessel distribution .  Infa rct volume was measured by operator-assisted computerized planimetry . RESULTS One hundred thirty-two patients had visible new supratentorial infa rcts , with median infa rct volume of 28.0 cm3 ( interquartile range , 9.0 to 93.0 cm3 ) . Fifty-nine patients had no visible new infa rct . Correlations with st and ard 3-month outcome scales and mortality were as follows : Barthel Index , r=0.43 ; Glasgow Outcome Scale , r=0.53 ; National Institutes of Health Stroke Scale , r=0.54 ; mortality , r=0.31 . For visible infa rcts alone , correlations were as follows : BI , r=0.46 ; GOS , r=0.59 ; NIHSS , r=0.56 ; mortality , r=0.32 . CONCLUSIONS Subacute CT infa rct volume correlates moderately with 3-month clinical outcome as assessed by widely used neurological and functional assessment scales . The modesty of this linkage constrains the use of infa rct volume as a surrogate end point in ischemic stroke clinical trials CONTEXT Prompt and precise measurement of neuronal damage in acute cerebral infa rct ion is important to determine the prognosis of functional outcome . A feasible biochemical marker such as the neuron-specific enolase ( NSE ) level has been used to detect various diseases involving the central nervous system . OBJECTIVE To determine whether the initial serum NSE level is a useful marker for predicting the severity of clinical neurological deficits and the extent of neuronal damage in acute anterior-circulation infa rct ion . DESIGN Case-control study with biochemical-clinicoradiological correlation . SETTING Tertiary care center . PARTICIPANTS Eighty-one patients and 77 age- and sex-matched control subjects . MAIN OUTCOME MEASURES Patients with anterior-circulation infa rct ion underwent intravenous serum NSE sampling within 24 hours after symptom onset . Recent infa rct ion was confirmed by T2-weighted and diffusion-weighted magnetic resonance imaging of the brain about 1 week after the onset of stroke . Volumetric analysis of infa rct ion was also performed . The National Institutes of Health Stroke Scale score was measured on admission to the hospital and 1 week after symptom onset . RESULTS The patients ' initial serum NSE levels were statistically significantly higher than the controls ( P<.05 ) . The initial serum NSE level highly correlated with the volume of infa rct ion seen on T2-weighted magnetic resonance imaging of the brain ( r = 0.62 , P<.001 ) and with the National Institutes of Health Stroke Scale score obtained on hospital admission ( r = 0.42 , P = .002 ) and on the seventh day after the onset of stroke ( r = 0.44 , P<.001 ) . CONCLUSION The initial serum NSE level is a reliable predictor for the extent of neuronal damage and the severity of clinical neurological deficits in acute anterior-circulation infa rct ion Background and Purpose — A simple , easily measured surrogate outcome measure for use in early treatment trials for acute ischemic stroke therapies would be highly valued . We hypothesized that day-5 NIH stroke scale score ( NIHSS ) and day-5 diffusion weighted imaging ( DWI ) volume would predict clinical outcome better than either alone and could be considered as a possible surrogate outcome in early phase acute stroke trials . Methods — The prospect i ve Acute Stroke Accurate Prediction ( ASAP ) trial included a prespecified subgroup evaluated for early outcome .  Logistic regression analysis was used to assess the prediction of modified Rankin ( mRankin ) of 0 or 1 . Results — A total of 204 subjects completed the sub study , and 116 ( 57 % ) had excellent outcome at 3 months . The area under the ROC curve ( AUC ) for day-5 NIHSS predicting 3-month excellent outcome was 0.84 ; for DWI volume predicting outcome was 0.76 , and for the multivariable model combining both was 0.84 . Conclusions — The results of the early outcome sub study of the ASAP trial suggest that early stroke severity and infa rct volume measures are predictive of 3-month excellent outcome . In our data set the DWI volume does not add clinical ly relevant information in predicting 3-month outcome . Validation of these results is required OBJECTIVE To determine the value of measuring serum levels of neuron-specific enolase in predicting extent of disease and short- and long-term functional outcome after acute cerebral infa rct ion . DESIGN Prospect i ve study . SETTING Neurology departments at two university teaching hospitals , Shanghai . PATIENTS Thirty-eight patients who presented for acute cerebral infa rct ion between October 1998 and October 2000 were divided into two groups : those whose infa rct ion extended to the cerebral cortex in the carotid artery region ( cortical group ) and those with an infa rct ion in the subcortical carotid artery region ( subcortical group ) . MAIN OUTCOME MEASURES Using a solid-phase enzyme immunoassay , we measured serum levels of neuron-specific enolase  on admission and on days 2 , 3 , and 15 . Infa rct volume was measured by computed tomography on day 5 . The Activities of Daily Living scale was used to assess the clinical outcome at 1- , 3- , and 6-month follow-up after onset . RESULTS Mean ( st and ard deviation ) serum neuron-specific enolase levels were significantly higher among patients with acute cerebral infa rct ion than among controls ( 18.48 [ 16.61 ] ng/mL versus 9.00 [ 2.70 ] ng/mL ; P<0.001 ) . The neuron-specific enolase level was also higher in the cortical group than in the subcortical group ( 33.54 [ 29.71 ] ng/mL versus 15.97 [ 5.91 ] ng/mL ; P<0.01 ) . Levels peaked after 2.11 ( 0.86 ) days and correlated positively with the infa rct volume ( r=0.81 ; P<0.01 ) and negatively with clinical outcome at 1 month ( r= -0.37 ; P<0.05 ) , 3 months ( r= -0.45 ; P<0.01 ) , and 6 months ( r= -0.65 ; P<0.001 ) , as assessed on the Activities of Daily Living scale . CONCLUSION Serum neuron-specific enolase levels after cerebral infa rct ion may be a useful marker to predict infa rct volume and short- or long-term functional outcome Objectives : The astroglial protein S100B is a marker of cerebral tissue damage . This study investigated whether the serum kinetic of S100B may serve as a surrogate marker of successful clot lysis and early recanalisation ( < 6 hours ) in hyperacute proximal middle cerebral artery ( MCA/M1 ) occlusion . Methods : The authors prospect ively included 23 patients ( mean ( SD ) age , 70.2 ( 11.0 ) years ) presenting with MCA/M1 occlusion on magnetic resonance angiography ( n=18 ) , intra-arterial angiography ( IA ; n=2 ) , or transcranial Doppler sonography ( TCD ; n=3 ) within five hours after symptom onset .  Rates of recanalisation and their point of time were determined using TCD or IA . Individual S100B values were determined at hospital admission , every eight hours within the first three days , and at 12 hour intervals from day 4 to day 6 . Additionally , the S100B area under the curve ( AUC ) and the S100B peak value were obtained . Results : Early recanalisation ( < 6 hours after symptom onset , n=7 ) was associated with a significantly lower mean S100B AUC compared with no recanalisation ( 22.2 ( 40.1 ) versus 406.8 ( 284.4 ) μg/l per hour ; p<0.001 ) . Using receiver operating calculations , a single S100B value obtained 48–96 hours after stroke onset of less than 0.4 μg/l ( cut off point ) provided a 86 % sensitivity and 100 % specificty for sufficient MCA/M1 clot lysis < 6 hours . The overall accuracy for a single S100B value obtained in the 48–96 hours time window was as high as for the AUC ( 95 
    Output:
    
The peak level and AUC over time of both markers correlated with subacute infa rct volume .
Measurements of S100-β later than 24 h after stroke were better correlated with subacute infa rct size than earlier measurements .
Conclusion : Peak and AUC levels of NSE and S100-β levels correlated with subacute infa rct volume .
Correlations of S100-β with infa rct volume were stronger when measured after 24 h than closer to admission .