PEDIATRICS Vol. 76 No. 1 July 1985, pp. 15-21
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Creatine Kinase Brain Isoenzyme: Relationship of Cerebrospinal Fluid Concentration to the Neurologic Condition of Newborns and Cellular Localization in the Human Brain

Gordon Worley MD1, Brian Lipman MD1, Ira H. Gewolb MD1, James A. Green PhD1, Donald E. Schmechel MD1, Charles R. Roe MD1, and Steven J. Gross MD1

1 From the Departments of Pediatrics and Internal Medicine, Duke University School of Medicine and Veterans Administration Medical Center, Durham, North Carolina, and Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut

Immunocytochemical study of human brain showed creatine kinase brain isoenzyme (CKBB) present in both neurons and astrocytes. Because creatine kinase brain isoenzyme is an intracellular enzyme that might be released with brain injury, its concentration in the CSF of newborns was measured using a radioimmunoassay. Infants who suffered a documented neurologic insult (a cerebroventricular hemorrhage or a CNS infection) were found to have a greater mean CSF creatine kinase brain isoenzyme concentration than those without a history of neurologic insult. Infants with a high concentration had a poor short-term outcome (death or neurologic abnormality when discharged) more frequently than did those with a lower concentration. Infants with a grade 3 or 4 cerebroventricular hemorrhage had a higher mean concentration than did those with a grade 1 or 2 hemorrhage. These data are consistent with the hypothesis that CSF creatine kinase brain isoenzyme is a metabolic indicator of brain damage in newborns.

Key Words: creatine kinase brain isoenzyme • cerebroventricular hemorrhage • brain damage

Submitted on November 28, 1983
Accepted on August 23, 1984




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M. Nussinovitch, G. Klinger, G. Soen, A. Magazanik, B. Volovitz, I. Varsano, and A. Nussinovitch
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[Abstract] [PDF]