S-100B protein is an established serum marker of brain damage in head injury and stroke. Despite the major progress in neurophysiologi-cal monitoring, there are still difficulties in the early identification and quantification of evolving structural damage after craniotomy for tumor. In this study we aimed to correlate S-100B values and early postoperative deterioration in meningiomas. We enrolled 50 patients who underwent meningioma resection. Serum S-100B was measured preoperatively and post-craniotomy for seven consecutive days. Twenty-five patients (50%) deteriorated and 35 (70%) had a favorable outcome. Elevated S-100B was highly correlated with larger tumors, intraoperative difficulties, and post-craniotomy deterioration. Our study shows that post-craniotomy elevation of serum S-100B is a reliable indicator of neurological deterioration.
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