Invasive and Ultrasound Based Monitoring of the Intracranial Pressure in an Experimental Model of Epidural Hematoma Progressing towards Brain Tamponade on Rabbits

Kasapas, Konstantinos; Diamantopoulou, Angela; Pentilas, N.; Papalois, Αpostolos; Douzinas, Emmanuel E.; Kouraklis, Gregorios; Slama, Michel; Terkawi, Abdullah Sulieman; Blaivas, Michael; Sargsyan, Ashot E.; Karakitsos, Dimitrios

doi:10.1155/2014/504248

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…In experimental animal models, this correlation would theoretically be much simpler to obtain. Kasapas et al 38 studied 20 rabbits with invasive ICP monitoring with intraparenchymal catheter and ONSD ultrasound in ICHy models using a SwanGanz catheter to simulate intracranial hematoma. They obtained an exponential correlation: r² = 0.62 ± 0.119 (p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension

Jeng

Andrade

Bor‐Seng‐Shu

et al. 2020

Preprint

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Background: Invasive monitoring of intracranial pressure is currently the only accepted method for the safe diagnosis and treatment of intracranial hypertension, but it is subject to hemorrhage, infection and malfunction. Ultrasound of the optic nerve sheath diameter is a non-invasive alternative that is cost effective and available at the bedside. The objective of this study was to correlate intracranial pressure and ultrasonography of the optic nerve sheath in an experimental animal model of cerebral hematoma. Materials and Methods: An experimental study was conducted on 30 male and female pigs wighing about 20 kg. The diameter of the optic nerve sheath was measured by ultrasound at different points of intracranial pressure. Intracranial pressure was simultaneously measured with an intraparenchymal catheter, and laboratory and hemodynamic data was collected from the animals. The values were correlated with each other to explore the application of this procedure in different clinical situations involving intracranial hypertension. Results: All the variables obtained by ONSD ultrasonography (Left Optic nerve LON, Rigth optic nerve RON and Avarage of Optic Nerve sheath AON) were statistically significant to predict the ICP value. AON presentation changes in relation to baseline from the moment of balloon inflation. AON proved to be the best parameter for predicting ICP and presented the best correlation. AON showed a delay of 30 minutes compared to ICP decrease, as it maintained values higher than baseline values at the ballon deflation moment (p = 0.016). Thus, intracranial pressure can be predicted using the linear function: -80.5 + 238.2 × the optic nerve sheath diameter. Conclusion: Optic nerve sheath diameter ultrasound is a reliable method for predicting intracranial pressure.

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Section: Resultsmentioning

confidence: 99%

Evaluation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension

Jeng

Andrade

Bor‐Seng‐Shu

et al. 2020

Preprint

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“…Numerous ultrasonographic measurements have been developed and validated for neuro-monitoring. Some of which include transcranial Doppler and pulsatility index, pupillary constriction velocity, and consensual sonographic PLR (Kasapas et al, 2014). Here we used the USG to monitor PD and consensual PLR.…”

Section: Discussionmentioning

confidence: 99%

Use of Bedside Ultrasound for Ophthalmic Evaluation in a Case of Traumatic Brain Injury: A Case Report

Karki,

Shrestha,

Neupane

et al. 2023

Nep J Oph

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Background: Ophthalmological examination is an important aspect of the neurological assessment in a patient with traumatic brain injury. However, significant periorbital swelling can make direct visualization of the pupils difficult. Ultrasonic examination can be a valuable bedside tool when direct visualization fails. Case: A case of a seven-year female child who had presented with a history traumatic brain injury is reported here. Observations: The periorbital swelling prevented the direct visualization of the eyes. Bedside evaluation with a multipurpose ultrasound (USG) was used to monitor the pupillary diameter (PD) and the consensual pupillary light reflex (PLR) at regular intervals. The PD was measured in the B-mode while the PLR was monitored in M-mode of the USG. The optic nerve sheath diameter (ONSD) was also monitored as a correlate of intracranial pressure (ICP). Conclusion: Ophthalmic evaluation of PD and PLR can be easily and objectively done on the bedside using USG especially in cases where the direct visualization of the pupils is difficult due to injuries and swelling of the periorbital tissues. Furthermore, ONSD measurements can also be done to monitor the changes in the ICP.

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“…To animal models, the intracranial hypertension is extremely mature. Konstantinos Kasapas et al successfully studied the invasive and ultrasound-based monitoring of intracranial pressure in an experimental model of epidural hematoma in rabbits [28]. Joacil Carlos da Silva et al studied the efficacy of hypertonic saline and mannitol in a model of fatal cranial hypertension [29].…”

Section: Discussionmentioning

confidence: 99%

Controlled Decompression Attenuates Brain Injury in a Novel Rabbit Model of Acute Intracranial Hypertension

et al. 2019

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This work was supported by Key Disciplines of Wuxi (ZDXK005) and Major Projects of Wuxi Health and Family Planning Commission (Z201705) Background: In the past, standard rapid decompressive craniectomy was used to alleviate the secondary damage caused by high intracranial pressure. Recent clinical studies showed that controlled decompression may have a better curative effect than rapid decompression. However, the effect on controlled decompression in animals is unclear. Material/Methods: Totally 80 healthy male New Zealand rabbits were randomly divided into a sham group (n=20), a rapid decompression group (n=30), and a controlled decompression group (n=30). An intracranial hypertension model was induced by injecting saline into an epidural balloon catheter and reducing ICP slowly and gradually by use of a pressure pump. The model was evaluated and analyzed by general observations, imaging examination, ICP values, behavioral score, brain water content, Nissl staining, and caspase-3 protein detection. Results: The mortality rate was 36.7% (11/30) in the rapid group, 20% (6/30) in the controlled group, and 5% (1/20) in the sham group. The incidence of epidural hematoma in the controlled group was lower than in the rapid group (p<0.01). The ICP was significantly lower in the controlled group than in the rapid group (p<0.001), and the behavioral score in the rapid group was higher than in the controlled group (p<0.05). There was a marked difference in brain water content between the controlled group and the rapid group (p<0.01). Nissl staining demonstrated that the ratio of Nissl body in the controlled group was significantly higher than in the rapid group (p<0.01). WB detection showed the expression of Caspase-3 in the controlled group was lower than in the rapid group (p<0.05). Conclusions: The results show the advantages of use of controlled decompression with intracranial hypertension. The animal model we developed provides a platform for further research on controlled decompression.

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Invasive and Ultrasound Based Monitoring of the Intracranial Pressure in an Experimental Model of Epidural Hematoma Progressing towards Brain Tamponade on Rabbits

Cited by 8 publications

References 26 publications

Evaluation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension

Evaluation of Intracranial Pressure by Ultrasound of the Optic Nerve Sheath in an Animal Model of Intracranial Hypertension

Use of Bedside Ultrasound for Ophthalmic Evaluation in a Case of Traumatic Brain Injury: A Case Report

Controlled Decompression Attenuates Brain Injury in a Novel Rabbit Model of Acute Intracranial Hypertension

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