Biomarcadores séricos en el traumatismo craneoencefálico: utilidad clínica actual
DOI:
https://doi.org/10.70577/hcx64d58Palabras clave:
Traumatismo craneoencefálico, biomarcadores séricos, GFAP, UCH-L1, S100B, tomografía computarizada, pronóstico neurológico.Resumen
Introducción: El traumatismo craneoencefálico es una entidad clínica heterogénea cuya evaluación, especialmente en los casos leves, puede resultar limitada mediante la exploración neurológica, la escala de coma de Glasgow y las reglas de decisión clínica. En este contexto, los biomarcadores séricos han surgido como herramientas complementarias para detectar lesión intracraneal, orientar la tomografía computarizada y estimar el pronóstico. Objetivo: Analizar la utilidad clínica actual de los principales biomarcadores séricos en el traumatismo craneoencefálico, con énfasis en su valor diagnóstico, pronóstico y de seguimiento.
Metodología: Se realizó una revisión narrativa estructurada con búsqueda sistematizada en PubMed, Scopus y ScienceDirect. Se identificaron 654 registros, se eliminaron 19 duplicados y se evaluaron 90 artículos a texto completo. Finalmente se incluyeron 25 artículos por su pertinencia con los objetivos de la revisión y su contribución al análisis de la utilidad clínica de los biomarcadores séricos en el traumatismo craneoencefálico.
Resultados: GFAP y UCH-L1 mostraron mayor utilidad para descartar lesiones intracraneales por su elevada sensibilidad y valor predictivo negativo, aunque con especificidad limitada. S100B presentó resultados favorables como prueba de descarte, especialmente en población pediátrica, pero su rendimiento depende de la ventana temporal y de la presencia de lesiones extracraneales. NfL y tau mostraron mayor interés para valorar daño axonal, evolución neurológica y resultados funcionales. Conclusión: Los biomarcadores séricos no sustituyen la valoración clínica ni la tomografía computarizada. Su mayor utilidad se obtiene cuando se integran con reglas de decisión, neuroimagen y seguimiento temporal.
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Derechos de autor 2026 Jimmy Fernando Yaguana Torres, Wendy Scarlett Medina Yaguana, Irene Diana León Valdiviezo, Fernanda Nicole Iñiguez Navarrete, Yiliam Ahylie Rojas Hidalgo (Autor/a)
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