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Pediatric NeuroNews - Blunting the Stress of Shunt Maintenance

Pediatric NeuroNews Winter 2015

Blunting the Stress of Shunt Maintenance

Date: November 28, 2014


George Coles, Sybil Klaus and Eric Jackson pooled their unique perspectives to create the prototype of a noninvasive method for reading intracranial pressure.
George Coles, Sybil Klaus and Eric Jackson pooled their unique perspectives to create the prototype of a noninvasive method for reading intracranial pressure.

Children whose hydrocephalus was treated with a permanently installed shunt may endure a distressing cycle: If they have a fever, headache or other symptoms of being generally unwell, they’re rushed to the emergency department to see if they have one of childhood’s typical viral infections or if their ventriculoperitoneal shunt is malfunctioning. Because infections and shunt problems often share the same symptoms—and shunt failure rates are high—it can be hard to distinguish between the two. Consequently, X-rays and CT scans are often the only way to tell whether the needed treatment is simply rest and supportive care or emergency surgery.

“It takes a huge emotional and physical toll on patients and their families,” says Johns Hopkins pediatric hospitalist Sybil Klaus.

But Klaus and her Johns Hopkins colleagues Eric Jackson, a pediatric neurosurgeon, and George Coles, a senior engineer at the Applied Physics Laboratory (APL), want to help change this scenario. The three are collaborating on a device to help physicians determine, noninvasively and without radiation, if a shunt is failing. Now patent pending, the device will measure intracranial pressure in the shunt through an external, handheld device. With a simple reading, doctors will better know whether symptoms are related to intracranial pressure, and thus, the shunt.

The principle investigators on this project came together after Klaus saw Coles present another of his recent designs: a device installed in cardiac stents that delivers thrombolytic agents when it senses a clot. A pressure gauge is a pivotal component of this sensor. After attending this presentation, Klaus wondered why no one had developed a similar pressure gauge for cerebral shunts. She brought in Jackson to offer expert advice on what features such a device might need to succeed with patients and the physicians who typically care for them.

“The idea behind the collaboration,” Jackson says, “is that it’s hard for us as physicians to step outside the box of seeing only the medical problems. The engineers at APL think about things from a very different perspective and can bring different ideas in.”

 Though the device is still years away from production, the researchers have constructed a prototype that serves its intended purpose of remotely reading intracranial pressure.

“The conditions that require a shunt bring enough stress,” says Jackson. “If we can reduce the added stress of shunt maintenance, that would be ideal.”

TO REFER A PATIENT OR FOR MORE INFORMATION: 410-955-7337