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The Scientific World Journal
Volume 2014, Article ID 504248, 10 pages
Research Article

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

1Department of Neurosurgery, Athens General Hospital “G. Gennimatas”, 11527 Athens, Greece
22nd Department of Surgery, Athens Medical School, Laiko University Hospital, 11527 Athens, Greece
3Intensive Care Unit, Athens General Hospital “G. Gennimatas”, Athens, Greece
4Experimental Research Center ELPEN, 19009 Athens, Greece
53rd ICU Department, Athens Medical School, Evgenideio University Hospital, 15128 Athens, Greece
6ICU, Amiens University Hospital, 80054 Amiens, France
7Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22903, USA
8Department of Anesthesiology, King Fahad Medical City, Riyadh 11525, Saudi Arabia
9Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC 29225, USA
10Wyle Science, Technology & Engineering Group/NASA Bioastronautics, Houston, TX 77058, USA

Received 30 August 2013; Accepted 12 November 2013; Published 21 January 2014

Academic Editors: H. Morimatsu and O. B. Paulson

Copyright © 2014 Konstantinos Kasapas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. An experimental epidural hematoma model was used to study the relation of ultrasound indices, namely, transcranial color-coded-Doppler (TCCD) derived pulsatility index (PI), optic nerve sheath diameter (ONSD), and pupil constriction velocity () which was derived from a consensual sonographic pupillary light reflex (PLR) test with invasive intracranial pressure (ICP) measurements. Material and Methods. Twenty rabbits participated in the study. An intraparenchymal ICP catheter and a 5F Swan-Ganz catheter (SG) for the hematoma reproduction were used. We successively introduced 0.1 mL increments of autologous blood into the SG until the Cushing reaction occurred. Synchronous ICP and ultrasound measurements were performed accordingly. Results. A constant increase of PI and ONSD and a decrease of values were observed with increased ICP values. The relationship between the ultrasound variables and ICP was exponential; thus curved prediction equations of ICP were used. PI, ONSD, and were significantly correlated with ICP (, , and , resp. (all )). Conclusion. Although statistically significant prediction models of ICP were derived from ultrasound indices, the exponential relationship between the parameters underpins that results should be interpreted with caution and in the current experimental context.