Brain monitor

Scientists develop minimally invasive method to gauge intercranial pressure. System receives the support of World Health Organization for dissemination in Latin America.

By Elton Alisson

Agência FAPESP – Professor Sérgio Mascarenhas, coordinator of the Institute of Advanced Studies at Universidade de São Paulo São Carlos (USP - São Carlos) often says that the wretched disease - normal pressure hydrocephalus (NPH) – that he battled six years ago has become a blessing.

Exasperated by the fact that at the time of his diagnosis modern medicine still relied on cranial perforation to gauge intercranial pressure (ICP), Mascarenhas developed a simple and minimally invasive method of gauging ICP in patients with NPH and cranial traumatism. The new method could have multiple uses.

Comprised of a chip placed outside a patient’s head through a small incision, and an external monitor which receives and monitors information about cranial bone deformation – which is proportional to the ICP – the method has received the support of the Pan-American Health Organization (PAHO) to be disseminated in Brazil and throughout Latin America.

“The Health Ministry’s idea, under the auspices of the Secretary of Science, Technology and Inputs, is for the method be used in ambulances in Brazil in order to evaluate the intercranial pressure of traffic accident patients and obtain urgent diagnoses,” Mascarenhas explains to Agência FAPESP. 
 
In 2009, under a project entitled “Development of minimally invasive monitoring equipment for intercranial pressure” funded by FAPESP through an Innovative Research in Small Businesses (PIPE) grant, the method was the subject of a doctoral project by researcher Gustavo Henrique Frigieri Vilela, conducted during his FAPESP fellowship. The method was initially tested on patients with cerebral traumatism at the Hospital das Clínicas de Ribeirão Preto, the hospital run by USP - Ribeirão Preto’s Medical School.

It was later tested in diverse applications, such as diagnosis and monitoring of stroke patients. “Using the method, health professionals can follow the neurological impacts of a stroke and take the appropriate measures to save lives or reduce the sequelae in patients,” explains Mascarenhas.

The device is also being studied for monitoring patients with brain tumors – which increase the volume of internal pressure on brain and ICP – as well as for diagnosis of brain death, when ICP disappears.

Other possible applications for the equipment are in pharmacology to gauge the effect of drugs that act on the chemical imbalances in the brain that alter intercranial pressure – such as migraines – and in veterinary sciences to measure intercranial pressure of large animals, such as bulls and hogs, in order to determine the presence of encephalitis – which increases the brain and ICP.

But, according to the researcher, the greatest advances in the application of the method were obtained in the diagnosis and monitoring of cranial traumatism and epilepsy. “For the first time, it was possible to measure the intercranial pressure of an epileptic patient during a convulsion. You cannot perforate the head of a patient to observe this,” says Mascarenhas.

International Patient

The system was patented in Brazil. Now the researcher’s objective is to register it at the National Health Surveillance Agency (Anvisa), the National Institute of Metrology, Standardization and Industrial Quality (Inmetro) and to file a global patent to prevent illegal duplication of the method.

While registering at Brazilian and international organizations, the researcher also intends to create a company called Brain Care to begin manufacturing equipment on an industrial scale and meet the demand that is emerging as a result of its future usage in SAMU ambulances.

With this, the Brazilian method should compete with the imported sensors found on the market, which in addition to being more expensive, are implanted inside a patient’s brain. “The advantages of our methods are that in addition to being much cheaper, the protection against infections that invasive methods require is not necessary. This way, the devices can be used for poorer people who do not have access to this technology,” explains Mascarenhas.
 
Valiant researcher

A retired USP professor, Mascarenhas contributed to the creation of the research area for condensed matter physics at USP- São Carlos at the end of the 1950s; of the Livestock Instrumentation area at the Brazilian Agricultural Research Corporation (Embrapa) in the same city, and at the Universidade Federal de São Carlos (UFSCar) in the following decade.

A visiting professor at several foreign universities, in his research Mascarenhas dealt with several subjects like electrets, which are used globally to product microphones and telephone sets.

At the beginning of his career, he focused on studying the thermodielectric effect. Later, he also conducted studies on radiation dosimetry (a process of monitoring radiation emissions), which allowed him, for example, to measure the quantity of radiation found in the bones of Hiroshima victims.

In 2007, he won the Conrado Wessel Award in General Science and in 2002 the Brazilian Grand-Cross of the National Order of Scientific Merit.