Glioblastoma (GBM) is one of the most aggressive malignant tumors of the brain. We queried PubMed for articles about molecular predictor markers in GBM. This scoping review aims to analyze the most important outcome predictors in patients with GBM and to compare these factors in terms of absolute months of survival benefit and percentages. Performing a gross total resection for patients with GBM undergoing optimal chemo- and radiotherapy provides a significant benefit in overall survival compared to those patients who received a subtotal or partial resection. However, compared to IDH-Wildtype GBMs, patients with IDH-Mutant 1/2 GBMs have an increased survival. MGMT promoter methylation status is another strong outcome predictor for patients with GBM. In the reviewed literature, patients with methylated MGMT promoter lived approximately 50% to 90% longer than those with an unmethylated MGMT gene promoter. Moreover, KPS is an important predictor of survival and quality of life, demonstrating that we should refrain from aggressive surgery in important brain areas. As new therapies (such as TTFs) emerge, we are optimistic that the overall median survival will increase, even for IDH-Wildtype GBMs. In conclusion, molecular profiles are stronger outcome predictors than the extent of neurosurgical resection for GBM.

Background/Objectives: Acute subdural hematomas (aSDH) represent a frequent and potentially life-threatening form of traumatic intracranial hemorrhage. This study aims to assess prognostic factors associated with mortality and clinical outcome, with particular emphasis on coagulation-related parameters, especially international normalized ratio (INR). Methods: A single-center retrospective cohort study was performed. We included 151 patients with traumatic aSDH, admitted between January 2020 and June 2025 to the Department of Neurosurgery of the Clinical Emergency Hospital “Saint Pantelimon”. Demographic, clinical, laboratory, and imaging parameters obtained at admission were analyzed. Univariate and multivariable regression analyses were performed to identify predictors of in-hospital mortality. Internal validation included bootstrap resampling, calibration analysis, penalized regression and spline modeling. Results: The cohort had a mean age of 67.4 years and was predominantly male (72.8%). Overall, in-hospital mortality was 36.4%, while 58.3% of patients underwent surgical intervention. Admission Glasgow Coma Scale (GCS) score represented the strongest predictor of mortality. Hematoma thickness was significantly associated with midline shift, mortality, and surgical intervention. Elevated INR was significantly associated with increased hematoma thickness, greater midline shift, lower GCS, and increased mortality. In multivariable analysis, INR ≥ 1.4 remained independently associated with mortality (OR 4.08, 95% CI 1.56–11.29, p = 0.005), together with lower GCS. The final model demonstrated very good discrimination (AUC 0.887) and good calibration. Conclusions: Outcome in traumatic aSDH appears to be influenced by neurological severity, hematoma burden, and coagulation status. Admission GCS remained the strongest predictor of mortality, while elevated INR independently predicted poor outcome.

Despite significant advances in neurosurgical and critical care, traumatic brain injury (TBI) remains a major cause of morbidity and mortality. Surgical treatment of intracranial hemorrhagic lesions can only target the primary mechanical injuries and their immediate consequences but fails to address the biochemical pathological cascade that unfolds during the second injury. This review synthesizes current knowledge regarding the use of several biomarkers in diagnosis and prognosis assessment. A structured literature search was conducted by querying the PubMed database. Articles evaluating diagnostic and prognostic biomarkers in adult TBI were screened according to Prisma guidelines, and data regarding biomarkers type, cut-off values, and correlations with the outcome were extracted and summarized. Among Central Nervous System (CNS)-Specific markers, S100 calcium-binding protein (S100B) emerged as a remarkably strong negative predictor for Computed Tomography (CT)-visible intracranial lesions (NPV = 97.3–100%), whereas glial fibrillary acidic protein (GFAP) yielded both high NPV and brain specificity. Coagulation parameters such as the international normalized ratio (INR) and fibrinogen were independently correlated with mortality and unfavorable outcomes. Fibrinogen displayed a bidirectional relationship with increased mortality risk at both low (4.5 g/L) values. In conclusion, biomarkers quantify the otherwise invisible progression of secondary traumatic brain injury that persists even after successful surgery.