Cape Town - A UCT paediatric neurosurgeon has developed a new, more accurate and non-invasive way to measure pressure on the brains of children, doing away with the need for costly surgery.
Thinking of the eye as the window to the brain, Llewellyn Padayachy and his team take 10-second ultrasound videos, using a probe placed over the child’s eye, to analyse the pulse-related dynamics as a marker of increased pressure in the brain.
Sound waves are transmitted to and reflected by the substance of the brain, giving an indication of the amount of pressure on it.
The shape and size of the eye sheath also gives an indication of the pressure on the brain.
Pressure on the brain can be an indication of illness and tumours. Because it is cheaper, quicker and less traumatic, the ultrasound technique means more children can be diagnosed and treated sooner.
Traditionally, surgeons would have to drill a hole through the skull to test for pressure on the brain as a way to diagnose tumours and infections.
The new way builds on an existing method, which takes an ultrasound “snapshot”, but Padayachy says the snapshot method is not always accurate, as its interpretation is quite variable.
The three-year study involved 200 children at the Red Cross War Memorial Children’s Hospital.
Padayachy used both the traditional method and the new method of taking an ultrasound video.
He said the results “showed excellent agreement”. Because the ultrasound technology is cheaper it means more children can be tested earlier on.
Two-thirds of patients seen by paediatric neurosurgeons need to be tested for pressure on the brain.
Drilling through the skull is costly and traumatic for the child.
“This means we can pick up raised pressure far earlier and start the necessary treatment,” he said.
“It is most beneficial when applied to children with neurological disease, in a resource-limited setting such as in South Africa, as they can be spared the unnecessary exposure to harmful radiation, anaesthesia and surgery.”
The vast majority of children that Padayachy and his team treat come from the most impoverished and rural communities in South Africa and increasingly from the rest of the continent.
“These children all share one uncomfortable problem: they always arrive for ‘brain inspection’ later than they should,” Padayachy said.
“We have expanded the use of this non-invasive modality both as a neuro-navigation tool and as a diagnostic tool to facilitate early diagnosis in children with raised pressure in the brain.”
Cape Times