Device may one day help babies with hydrocephalus

Babies born premature are at risk of developing hydrocephalus. According to the NIH, about 15% need surgery to implant a shunt but sometimes that surgery is unsuccessful or unnecessary.

To better understand what’s happening inside the brain, local doctors have developed a cap called a cap-based transcranial optical tomography (CTOT) that can help them see what’s happening inside the head.

When five-year-old Aries was born at 23-weeks gestation, his mother knew they would have challenges to face. She said if they had something like CTOT to see fluid inside of his brain, it would’ve made things easier on their family.

“We attempted to do something called a left reservoir placement. It’s a tiny piece of plastic implanted in the brain to help drain some of the fluid. The thought was that at some point the bleeds within his head would resolve and that fluid would naturally drain down the spine like it’s supposed to. That was unsuccessful,” Aisha Atkinson explained a variety of operations Aires had. “I think it was a 40% chance, if I’m remembering correctly... but it too was unsuccessful.”

VIDEO: Watch an interview below with Dr. Shah and Atkinson.

There’s no technology currently available that could’ve changed the outcome of surgeries for him, which is why Atkinson agreed to be part of a clinical trial for a device (CTOT) that can detect how fluid is draining in the brain.

“In terms of shunt failure, a third of patients who have a shunt put in will fail their first year or need another surgery,” said Dr. Manish Shah, UT Health pediatric neurosurgeon. “It’s going to show us whether the fluid is being reabsorbed or not. So, we have a hypothesis linked to all this. If the fluid is not being reabsorbed in a certain way, then maybe they’d be a better candidate for the shunt procedure versus if the fluid is being absorbed this way... then maybe they’d be a good candidate for endoscopy.”

Shah said there’s a photo where he’s holding baby Aries and said it is a pivotal first moment in the device that, if approved by the FDA, could one day help babies with hydrocephalus.

“It was such a great moment because I knew that one day this is going to help, maybe not this boy, but somebody else,” Shah said. “That’s like that’s the dream of every scientist to see their work help a child or a patient.”

Shah and his team plan to submit data to the FDA by the end of year which will bring this one step closer to patient use.

Atkinson hopes being part of the study can improve the odds for all kids born with hydrocephalus.

“That cap, you know, had it been something that was ready for daily use intervention, Dr. Shah would have been able to, you know, see... what was the appropriate intervention for him as opposed to kind of trying to guess what would work and what would not work,” Atkinson said.

At this time, there is no cure for hydrocephalus. Even though there are interventions, it’s hard to tell who a great candidate would be.