Evaluation of the intracranial pressure curve in pediatric through the non-invasive method

Introduction: Intracranial hypertension (HI) is a secondary clinical condition resulting from the loss of controlled compensatory controls, leading to increased intracranial pressure (ICP) and changes in cerebral blood flow, which may result in hypoxia, brain damage and hernia. Brain4care (b4c) is a device that explores variations in intracranial compliance and allows the measurement of ICP in a non-invasive and serial way, in addition, it can predict the trend of evolution of the clinical syndrome of HI. Objective: To evaluate the concordance of monitoring with the Brain4care device in acute changes in intracranial compliance with CSF puncture with manometry. Hypothesis that Brain4care can be used as a tool to aid in the detection of intracranial compliance variation. Method: Observational and cross-sectional study, carried out in a reference pediatric hospital in Brazil, in patients with signs and symptoms of IH and neurologically healthy patients. After neurological medical evaluation, the following tests were performed – non-invasive monitoring of ICP with B4C, ophthalmoscopy, tomography (CT), magnetic resonance imaging (MRI) and lumbar puncture and brain4care monitoring. Result: Performed to date the epidemiological profile of patients with signs and symptoms of intracranial hypertension, 58 patients with signs and symptoms of intracranial hypertension were evaluated, 32 females (55.2%), 26 males (44, 8%) and a median age was 10 (3-17). Most patients had symptoms such as drowsiness (81%), nausea (77.6%), headache (74.1%), vomiting (63.8%) and dizziness (53.4%). The ophthalmological examination in 77.6% (n=58) of the patients showed no signs of papilledema. At CT and MRI, no alterations were found in 84.5% (n=58) and 69.2% (n=26), respectively. Lumbar puncture was abnormal in 57.1% (n=21). Based on published studies of b4c values in the adult population, monitoring with the device (N=58) showed a possible change in sitting and lying position of 46.3% and 38.9% respectively in pediatric patients. Conclusion So far, it has been possible to describe the profile of pediatric patients monitored by a non-invasive device with signs and symptoms of IH, which has not yet been described in the literature. Furthermore, the b4c device provides a possible complement of clinical information in the brain compliance monitoring process.