Multiparametric characterisation of the perihemorrhagic zone in a porcine model of lobar ICH.


OBJECTIVES To describe early perihemorrhagic changes after lobar intracerebral hemorrhage (ICH) using multiparametric neuromonitoring [intracranial pressure (ICP), cerebral blood flow (CBF), tissue oxygenation (PbrO2), microdialysis (MD)]. METHODS Seven anaesthetized male swine were examined over 12 h. Four cerebral probes were inserted around the ICH (ICP, MD, CBF and PbrO2). A right frontal autologous arterial ICH (1.5 mL) was induced in all animals. RESULTS Initial ICH creation was hampered by using a soft 22-G cannula. A modified injection technique with a 90° bent steel cannula (20 G) allowed for an 87.5% success rate in ICH formation. After induction of ICH, ICP significantly increased from 2 mmHg to 9 mmHg. No significant PbrO2 or CBF reduction occurred during the monitoring period. Consequently, microdialysis did not indicate overall mean deterioration in the hematoma group over time. The indicator of ischemia (extracellular lactate) did not increase significantly during the monitoring period. Individual monitoring episodes demonstrated hypoxic episodes with consecutive metabolic derangement. These effects were reversible by optimizing CPP and FiO2. CONCLUSION We established a reproducible cortical ICH model using multiparametric neuromonitoring. Subtle changes in ICP were observed. No evidence for the existence of a perihemorrhagic ischemic area was found, hypothetically because of the small hematoma size. Individual animals underwent critical PbrO2 and CBF decreases with consecutive metabolic derangement. The effect of larger hematoma volumes should be evaluated with this setup in future studies to study volume-dependent deterioration.

DOI: 10.1007/978-3-7091-0693-8_4

Cite this paper

@article{Orakcioglu2011MultiparametricCO, title={Multiparametric characterisation of the perihemorrhagic zone in a porcine model of lobar ICH.}, author={Berk Orakcioglu and Modar M Kentar and Yoichi Uozumi and Edgar Santos and Patrick Schiebel and Andreas Unterberg and Oliver W. Sakowitz}, journal={Acta neurochirurgica. Supplement}, year={2011}, volume={111}, pages={19-23} }