Epidemiologic profile of pediatric patients with signs and symptoms of intracranial hypertension and monitoring of brain compliance using a non-invasive device in a referral pediatric hospital in Brazil

Background: Intracranial hypertension (IH) is a secondary clinical condition due to the loss of brain compensatory mechanisms, leading to increased intracranial pressure (ICP) and changes in cerebral blood flow, which can result in hypoxia, brain injury, and herniation. 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 evolution trend of the IH clinical syndrome.

Objective: To characterize the epidemiological profile of patients with signs and symptoms of IH in the pediatric age group and describe the results of the tests used to assess the clinical condition.

Methods: Observational and cross-sectional study has been carried out in a reference pediatric hospital in Brazil, in patients with signs and symptoms of IH. After a neurological medical evaluation, the following tests were performed – non-invasive ICP monitoring with B4C, ophthalmoscopy, tomography (CT), magnetic resonance imaging (MRI), and lumbar puncture.

Results: To describe the epidemiological profile of IH 58 patients were evaluated, of which 32 were female (55.2%), 26 were male (44.8%), and the 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%). Ophthalmoscopic examination on 77.6% (n= 58) patients did not show signs of papilledema. On CT and MRI, no changes were found in 84.5% (n= 58), and 69.2% (n= 26), respectively. Lumbar puncture was abnormal in 57.1% (n= 21). Based on the published studies of the b4c values in the adult population, monitoring with the device (n= 58) showed a possible change in the sitting and lying position, respectively, of 46.3% and 38.9% in pediatric patients.

Conclusions: It was possible to describe the profile of pediatric patients monitored by a non-invasive device with signs and symptoms of IH, which so far has not been described in the literature. Furthermore, it was found that the b4c device provides a possible complement of clinical information in the process of monitoring brain compliance.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
18 September 2023