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GFAP is a protein found in the glial cells of neural tissue. Glial cells are non-neuronal cells that provide physical and metabolic support to neurons. Blood biomarker levels of GFAP reflect acute injury to brain tissue since the biomarker levels increase strongly and fast within hours after the trauma occurred. Therefore, it has potential use in the emergency unit and intensive care unit, directly after the TBI. Furthermore, the biomarker persists for an extended period with a half-life of 48 hours, making it a favourable biomarker to use in both the acute and subacute phases of injury. The concentration of GFAP peaks at about 20 hours after the injury. Reference serum levels of GFAP range from 0.02 — 0.35 𝜇g/L and the cut-off value of a negative CT scan for GFAP is 0.35 𝜇g/L.<ref name="Arti5">Papa, L., Brophy, G. M., Welch, R. D., Lewis, L. M., Braga, C. F., Tan, C. N., Ameli, N. J., Lopez, M. A., Haeussler, C. A., Mendez Giordano, D. I., Silvestri, S., Giordano, P., Weber, K. D., Hill-Pryor, C., & Hack, D. C. (2016). Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury. JAMA Neurology, 73(5), 551. https://doi.org/10.1001/jamaneurol.2016.0039 </ref>
== History of TBI ==
=== Pre-historic period ===
TBIs play an important role in the evolution of humans. Studies of skeletons from the mesolithic period (c. 7000 BC) suggest an inverse relationship between the risk of skull fracture and the progress of civilization. The palaeolithic period is a period in prehistory that occurred over a million years ago. In those times, man's predecessor was a semi-erect hominid now named Australopithecus africanus; a damaged skull from this species found in South Africa reveals the first evidence of brain injury.<ref name="Arti6">Rose, F. C. (1997). The history of head injuries: An overview*. Journal of the History of the Neurosciences, 6(2), 154–180. https://doi.org/10.1080/09647049709525700 </ref>
One of the earliest methods used for treating TBI is called Trepanation. Trepanning, also known as trepanation, is a surgical intervention in which a hole is drilled or scraped into the human skull. The earliest evidence of trepanation performed by the man himself appears in the Neolithic period. The primary theories for the practice of trepanation in ancient times include spiritual purposes and treatment for epilepsy, headache, head wound, and mental disorders.
== References ==
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