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Prediction of intracranial hypertension through noninvasive intracranial pressure waveform analysis in pediatric hydrocephalus

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Abstract

Purpose

The purpose of this study is to evaluate a noninvasive device to assess intracranial pressure wave form in children with hydrocephalus.

Methods

A prospective and non-experimental descriptive-analytic study was performed. Fifty-six patients were enrolled in this study. They were divided in four groups: group A, children with clinically compensated hydrocephalus; B, surgically treated hydrocephalus; C, patients with acute intracranial hypertension due to hydrocephalus; and D, children without neurological disease (control). Data were collected through the installation of an extracranial deformation sensor, coupled to the children’s scalp, which allowed registration of noninvasive intracranial pressure curves. Parameters obtained were analyzed: P2/P1 ratio, “classification P1 and P2 and P1 slope.

Results

P2/P1 index and “classification of P1 and P2” had a sensitivity of 80% and specificity of 100% for predicting intracranial hypertension. “P1 slope” presented no statistical difference.

Conclusion

This study showed a useful and noninvasive method for monitoring intracranial pressure, which was able to indicate the intracranial hypertension in children with hydrocephalus and, thus, should be further investigated for clinical applications.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery of the Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, São Paulo, Brazil

    Matheus Fernando Manzolli Ballestero & Ricardo Santos de Oliveira

  2. Institute of Advanced Studies, University of São Paulo, Sao Carlos, Sao Paulo, Brazil

    Gustavo Frigieri, Brenno Caetano Troca Cabella & Sergio Mascarenhas de Oliveira

Authors
  1. Matheus Fernando Manzolli Ballestero
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  2. Gustavo Frigieri
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  3. Brenno Caetano Troca Cabella
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  4. Sergio Mascarenhas de Oliveira
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  5. Ricardo Santos de Oliveira
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Corresponding author

Correspondence to Matheus Fernando Manzolli Ballestero.

Ethics declarations

This study was approved by the local ethics committee and consent forms were obtained from the patient’s legal representative.

Conflict of interest

Gustavo Frigieri and Sergio Mascarenhas de Oliveira are paid consultants of BrainCare Corp. The other authors have no personal, financial, or institutional interest in any of the materials, or devices described in this article.

The NI system discussed is still investigational and not labeled for clinical use.

Funding

This study was funded by São Paulo Research Foundation–FAPESP.

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Ballestero, M.F.M., Frigieri, G., Cabella, B.C.T. et al. Prediction of intracranial hypertension through noninvasive intracranial pressure waveform analysis in pediatric hydrocephalus. Childs Nerv Syst 33, 1517–1524 (2017). https://doi.org/10.1007/s00381-017-3475-1

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  • DOI: https://doi.org/10.1007/s00381-017-3475-1

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