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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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Establishment of a cortical intracerebral hemorrhage in an experimental swine model: In vivo characterization of perihemorrhagic changes with a multiparametric neuromonitoring approach

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  • B. Orakcioglu - Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg
  • O. Sakowitz - Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg
  • P. Schiebel - Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg
  • M. Kentar - Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg
  • K. Kiening - Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg
  • A. Unterberg - Neurochirurgische Klinik, Ruprecht-Karls-Universität Heidelberg

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP05-12

doi: 10.3205/09dgnc304, urn:nbn:de:0183-09dgnc3049

Published: May 20, 2009

© 2009 Orakcioglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The pathophysiology of the perihemorrhagic zone (PHZ) in intracerebral hemorrhage (ICH) remains unclear. With the aim of characterizing perihemorrhagic changes we established an experimental multiparametric neuromonitoring. The description of the model will be presented containing first data.

Methods: Five male swine (30–35kg) were sedated, mechanically ventilated and 4 right parietal cerebral monitoring probes were inserted (ICP; CBF; PbrO2; microdialysis) into the (PHZ) of a cortically induced ICH. A right frontal autologous ICH was induced using the arterial blood pressure. A volume of 2ml was applied. Online monitoring of all relevant physiological parameters was permanently obtained up to 12 hours post ICH. The ICH volume was measured post mortem.

Results: A 2ml ICH was induced resulting in an immediate hypoperfusion. Microdialysates were inhomogeneous in this small volume group. The ICP progressively increased to pathologic values (greater than 15mmHg). Despite hemodynamic stability CBF was subsequently increased compared to baseline values. PbrO2 was not significantly affected in the 2ml volume group. Significant early CBF-increases reliably indicated a generalized seizure that could be interrupted with intravenous midazolam application.

Conclusions: We established an experimental, cortical ICH model in swine applying multiparametric neuromonitoring. This model will serve as a basis for further quantification of medical and surgical therapeutic effects after cortical ICH. ICP increases are compensated by reactive hyperperfusion resulting in stable PbrO2 values in the PHZ. Early classifiable neurometabolic effects of the ICH could not yet be detected. Further experimental studies with higher ICH volumes should clarify whether a volume dependent neurometabolic derangement will occur in the PHZ.