Hydrocephalus or ‘water on the brain’ is a neurological condition that is fatal unless a tube (shunt) is surgically implanted to drain excess cerebrospinal fluid from the brain. Patients and their caregivers live in constant fear that the shunt will block. Symptoms of shunt malfunction are non-specific (vomiting, headaches, irritability, and drowsiness) resulting in frequent unnecessary visits to the emergency department, particularly in children with the condition.
Seventy percent of these emergency department presentations are false alarms, leading to undue hospital admissions, expensive MRI or radioactive CT scans, personal costs, and stress. Due to this, hydrocephalus patients account for less than 1% of neurosurgical patients but require up to 10% of the neurosurgical budget.
Professor Simon Malpas of the Auckland Bioengineering Institute and Faculty of Medical and Health Science at the University of Auckland and a team of engineers, physiologists, and clinicians have previously received HRC funding for early prototyping, performance testing, and animal testing for an implantable sensor to enable remote measurement of brain pressure. The HRC recently funded the first in-human clinical trial which began in New Zealand in 2024 with 20 patients with hydrocephalus.
The team have developed a world-first microcomputer to measure pressure within the brain. The device is the size of a few grains of rice, weighing 0.3 grams, and is injected deep into the brain at the time of the shunt surgery (using the same drilled hole). To power the implant and receive the measured pressure data, a wand is held over the head near the sensor. The readings are then easily viewed in an app and can be securely sent to hospitals to allow remote and non-invasive monitoring of patients, whether required regularly or when symptomatic.
“This device is New Zealand’s first implantable medical technology and has been hailed by neurosurgeons as “a gamechanger”.
The technology has led to a new company, Kitea Health, created in 2022 to develop remote physiological monitoring through implantable devices.
The technology is being further tested through a larger scale Food and Drug Administration (FDA) trial, which began in 2025, involving patients in New Zealand and the United States (US). This will have an accelerated development and regulatory review process as Kitea Health was awarded Breakthrough Device Designation by the FDA in late 2024.
The device is New Zealand’s first implantable medical technology and has been hailed by neurosurgeons as a “gamechanger”. It has potential to revolutionise hydrocephalus treatment by allowing patients to monitor their brain pressure at home, thus reducing hospital costs (by an estimated 40%) and providing much needed reassurance for hydrocephalus patients and their whānau. It is expected to improve global management of hydrocephalus and bring timely, cost-effective care and economic benefits to New Zealand.
The Kitea system is also being trialled in the US for patients suffering from heart conditions, allowing them to monitor their conditions from home. It is estimated that it will reduce hospital admissions in the year following implantation by 62% and reduce healthcare costs by 32%.
The HRC has funded $4.4 million of Professor Malpas’ research into implantable medical technology since 2002, including three projects investigating implantable blood pressure sensors and an implantable heart device. Most recently, his team have been awarded $1.4 million in HRC funding to conduct the first human clinical trials of the novel implantable blood pressure device.
Useful links:
Malpas, S.C., Wright, B.E., Guild, SJ. et al. Long-term brain pressure monitoring via a discrete microimplant; a first-in-human safety and initial efficacy trial in adults and children with hydrocephalus. Nat Commun 17, 3158 (2026). https://doi.org/10.1038/s41467-026-70864-8