Division of Neurosurgery

Department of Clinical Neurosciences

Brain Physics Lectures

Brain Physics in 30 short lectures (not only for engineers)

By Dr. Marek Czosnyka (University of Cambridge Reader in Brain Physics).

Please click on the lecture number to download the presentation.

Lecture # Description
Lecture 1 Introduction
Lecture 1 Physics of cerebrospainal fluid (CSF) circulation in brain: Sites and mechanisms of CSF secretion, circulation and reabsorption. Physiological and modelling description.
Lecture 2 Cerebral blood flow and metabolism: Physiology of brain blood inflow, circulation and venous outflow. Architecture of cerebrovascular tree. Basic physics of blood flow
Lecture 3 Autoregulation of cerebral blood flow. Mechanisms of regulation: myonic, metabolic and chemical. Structure of arterial walls, role of endothelium. Macroscopic observations: Lassen's curve. Dynamic and static autoregulation. Clinical examples
Lecture 4 Intracranial pressure: measurement and monitoring: CSF pressure as a 'golden standard'. Intraparenchymal pressure. Sensors, drifts, errors and monitoring techniques
Lecture 5 Monitoring of cerebral blood flow: Various techniques: transcranial Doppler, laser Doppler flowmetry, thermal dilution, Near Infrared Spectroscopy
Lecture 6 Intracranial pressure (ICP) as a signal in physiology and patophysiology: ICP is more than the number. Waves and fluctuations of ICP, interpretation. Slow and respiratory waves. Spectral components of ICP
Lecture 7 Cerebral perfusion pressure: Definitions, source of instability. Implication on management protocols. What happens when CPP is too low, and when it is too high?
Lecture 8 Waveform analysis of intracranial pressure: Pulse analysis, high frequency centroids, morphological methods?
Lecture 9 Pressure reactivity: Relationship between ICP and arterial blood pressure (ABP). Pressure-reactivity index, computational methods. Clinical examples. Optimization of cerebral perfusion pressure: Relationship between Pressure Reactivity and CPP. Does 'optimal CPP' exist always? Implications on management.
Lecture 10 Pressure-volume compensatory reserve: Pressure-Volume Index, RAP index. Applications in hydrocephalus and head injury.
Lecture 11 Traumatic brain injury. Links between ICP, CPP, PRx monitoring and outcome after TBI. Does CT picture really help? Critical levels of CPP,ICP and PRx
Lecture 12 Modelling of CSF compensation: Mathematical model (Marmarou).
Lecture 13 Volume-pressure infusion tests: Typical patterns of infusion studies in different forms of CSF circulatory disorders.
Lecture 14 Resistance to CSF outflow: What it is and what it isn't. Use of the resistance to optimize management of hydrocephalus. Who needs a shunt?
Lecture 15 Cambridge, UK: short and long walks, Winnie the Pooh and history of Cam River punting.
Lecture 16 CSF shunts for treatment of hydrocephalus - construction and engineering of CSF hydrocephalus shunts: from historical to contemporary designs. Cambridge Shunt Evaluation Laboratory
Lecture 17 Shunt testing in-vivo: Use of infusion tests to assess shunt functioning after implantation: patterns of underdrainage and overdrainage. Slit ventricles syndrome. Overnight ICP monitoring
Lecture 18 Transcranial Doppler (TCD) Ultrasonography: vasospasm . Transcranial Doppler Pulsatility Index and other useful measures of blood transport in great cerebral vessels. Is Pulsatility index related to ICP? Is it a measure of cerebrovascular resistance?
Lecture 19 Use of Transcranial Doppler for monitoring of cerebral autoregulation.
Lecture 20 Compartmental compliances of brain: assessment of cerebral arterial compliance and lumped compliance of CSF and venous pool. Monitoring of Monro-Kelly doctrine: Mutual relationship between brain compartmental compliance as a marker when intracranial hypertension becomes 'refractory'
Lecture 21 Time constant of cerebrovasular system: applications in Common Carotid Artery Stenotic Disease and cerebral vasospasm following Subarachnoid Haemorrhage. Time constant versus ABP and ICP- experimental design
Lecture 22 Cerebrovascular impedance: Linear modelling of basal cerebral vessels. Is pulsation of blood transport greater than pulsation of arterial blood pressure? Why? Critical closing pressure (CCP)- theoretical concept versus clinical implications. Use of CCP to measure 'real CPP' or non-invasive estimate of ICP
Lecture 23 Non-invasive methods for ICP monitoring: transcranial Doppler flowmetry and other useful methods.
Lecture 24 Brain Biochemistry. Monitoring of cerebral tissue oxygenation: SJVO2, Licox, and NIRS. Cerebral microdialysis.
Lecture 25 Alternative indices of cerebrovascular reactivity: use of Near Infrared Spectropscopy, tissue oxygenation and others
Lecture 26 Modelling of cerebral blood flow: Integration of cerebral blood flow into Marmarou's model
Lecture 27 Experimental cerebrovascular dynamics: Projects, instrumentation, models.
Lecture 28 Software for brain monitoring: ICM+
Lecture 29 Other possible techniques for brain signal analysis. Summary