Devices For Measuring Cranial Pressure

Increased cranial pressure (ICP) in infants can be caused by a variety of different circumstances. The most common are encephalitis-an inflammation of the brain, most often caused by an infection, meningitis-an infection of the membrane covering the brain, and hydrocephalus-a buildup up fluid in the skull often caused by developmental malformations or masses that do not allow the cerebrospinal fluid to properly drain. Premature infants are also more prone to a specific type of hydrocephalus caused by intraventricular haemorrhage. Untreated increased cranial pressure can result in developmental delays, visual impairment, seizures, or brain injury. For these reasons, it is vital to detect and properly monitor increased cranial pressure in infants.

Non Invasive Cranial Pressure Measurement

One of the best and least invasive methods for measuring intracranial hypertension is the fontanometer. This device is placed on the anterior fontanelle and measures intracranial pressure using the principle of applanation. This principle states that the amount of force required to flatten an area of the fontanelle is proportional to the intracranial pressure. This method has proven to be rapid, painless, and accurate. Comparative studies have shown that in patients where direct ICP was measured by both ventricular puncture and applanation transducer, the transducer accurately measured intracranial pressure over a wide range.

What is a Fontanometer?

The fontanometer is a transducer that consists of a sensor with a metal diaphragm containing fine wires known as resistive strain gages. These strain gages operate of the principle of applied force where pressure causes the wires to increase in length. This process is known as strain and the stretching of these wires results in increased electrical resistance while contraction of the wire results in decreased electrical resistance. A rubber membrane or balloon over the sensor allows the baseline to be checked by equalising the pressure above and below the sensor. This design overcomes inaccuracies caused by zero offset. By injecting air to equalise pressure, it is possible to check the zero of both the transducer and the amplifier in situ.

The use of the fontanometer allows clinicians access to continuous intracranial pressure monitoring without resorting to invasive procedures. This results in the ability to not only detect ICP but to evaluate the efficacy of therapeutic measures to reduce intracranial pressure safely and precisely. Early detection and close monitoring of ICP greatly increases the likelihood of a positive outcome.

This type of measurement must only be carried out in a clinical environment by fully qualified practitioners.

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