Epidural Intracranial Pressure Measurement in Rats Using a Fiber-optic Pressure Transducer

Abstract

Elevated intracranial pressure (ICP) is a significant problem in several forms of ischemic brain injury including stroke, traumatic brain injury and cardiac arrest. This elevation may result in further neurological injury, in the form of transtentorial herniation(1,2,3,4), midbrain compression, neurological deficit or increased cerebral infarct(2,4). Current therapies are often inadequate to control elevated ICP in the clinical setting(5,6,7). Thus there is a need for accurate methods of ICP measurement in animal models to further our understanding of the basic mechanisms and to develop new treatments for elevated ICP. In both the clinical and experimental setting ICP cannot be estimated without direct measurement. Several methods of ICP catheter insertion currently exist. Of these the intraventricular catheter has become the clinical 'gold standard' of ICP measurement in humans(8). This method involves the partial removal of skull and the instrumentation of the catheter through brain tissue. Consequently, intraventricular catheters have an infection rate of 6-11%(9). For this reason, subdural and epidural cannulations have become the preferred methods in animal models of ischemic injury. Various ICP measurement techniques have been adapted for animal models, and of these, fluid-filled telemetry catheters(10) and solid state catheters are the most frequently used(11,12,13,14,15). The fluid-filled systems are prone to developing air bubbles in the line, resulting in false ICP readings. Solid state probes avoid this problem (Figure 1). An additional problem is fitting catheters under the skull or into the ventricles without causing any brain injury that might alter the experimental outcomes. Therefore, we have developed a method that places an ICP catheter contiguous with the epidural space, but avoids the need to insert it between skull and brain. An optic fibre pressure catheter (420LP, SAMBA Sensors, Sweden) was used to measure ICP at the epidural location because the location of the pressure sensor (at the very tip of the catheter) was found to produce a high fidelity ICP signal in this model. There are other manufacturers of similar optic fibre technologies(13) that may be used with our methodology. Alternative solid state catheters, which have the pressure sensor located at the side of the catheter tip, would not be appropriate for this model as the signal would be dampened by the presence of the monitoring screw. Here, we present a relatively simple and accurate method to measure ICP. This method can be used across a wide range of ICP related animal models.