Predictive Value of Serum Lactate Dehydrogenase in Head Injury

Background:Elevated serum lactate dehydrogenase (LD) as a marker for diagnosis and assessment of severity of head injuries has gained interest in recent years and some encouraging reports have appeared on assessing the degree of brain damage by estimating serum lactate dehydrogenase. Methods: Prospective observational study of 63 patients admitted at a trauma centre with head injuries in a 21⁄2-month span with no extracerebral injury. Upon admission, vital parameters were recorded and blood samples were drawn for serum LDH on 5 consecutive days. The patients were further evaluated by radiological tests.Results: Serum LDH was raised in patients with parenchymal brain injuries. Serum LDH was raised significantly in patients with contusion injury, followed by patients with diffuse axonal injuries. Patients with extracerebral hemorrhage have higher serum LDH than patients of cerebral odema. Serum LDH was highest in patients who died of head injury, suggesting that an increase in serum LDH activity indicated the degree of parenchymal brain damage. Serum LDH in children was found to be higher compared to that of adults in the same group of head injury (cerebral oedema); the reason remains to be investigated by further studies.