Brain Physics in 27 short lectures ( not only for Physicists 🙂 )
By Prof. Marek Czosnyka,
Chaired by Dr Peter Smielewski
A new series of FREE for all lectures delivered in June 2020. Â The lectures have been recorded for your viewing pleasure.
See what ICM+ can do for you – all the physiology facts and physics principles behind our flagship tool are laid bare for you.Â
| 3rd of June 13:00 | |
| Lecture 1 | Physics of cerebrospinal fluid (CSF) circulation in brain: Sites and mechanisms of CSF production, 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 |
| 4th of June 13:00 | |
| Lecture 3 | Autoregulation of cerebral blood flow. Mechanisms of regulation: myogenic, 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 |
| 5rd of June 13:00 | |
| Lecture 5 | Monitoring of cerebral blood flow: Various techniques: transcranial Doppler, laser Doppler flowmetry, thermal dilution, Near Infrared Spectroscopy |
| Lecture 6 | ICP is more than the number. Waves and fluctuations of ICP, interpretation. Slow and respiratory waves. Spectral components of ICP |
| 8th of June 13:00 | |
| 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? |
| 9th of June 13:00 | |
| 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 |
| 10th of June 13:00 | |
| 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 | Cambridge, UK: short and long walks, Winnie the Pooh and history of Cam River punting |
| 11th of June 13:00 | |
| Lecture 13 | Modelling of CSF compensation: Mathematical model (Marmarou). |
| Lecture 14 | Volume-pressure infusion tests: Typical patterns of infusion studies in different forms of CSF circulatory disorders. |
| 12th of June 13:00 | |
| Lecture 15 | 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 16 | CSF shunts for treatment of hydrocephalus – construction and engineering of CSF hydrocephalus shunts: from historical to contemporary designs. Cambridge Shunt Evaluation Laboratory. 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 |
| 15th of June 13:00 | |
| Lecture 17 | 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 18 | Use of Transcranial Doppler for monitoring of cerebral autoregulation |
| 16th of June 13:00 | |
| Lecture 19 | 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 20 | Time constant of cerebrovascular system: applications in Common Carotid Artery Stenotic Disease and cerebral vasospasm following Subarachnoid Hemorrhage. Time constant versus ABP and ICP- experimental design |
| 17th of June 13:00 | |
| Lecture 21 | Cerebrovascular impedance: Linear modelling of basal cerebral vessels. Is pulsation of blood transport greater than pulsation of arterial blood pressure? Why? Critical closing pressure (CrCP)- theoretical concept versus clinical implications. Use of CrCP to measure ‘real CPP’ or non-invasive estimate of ICP |
| Lecture 22 | Non-invasive methods for ICP monitoring: transcranial Doppler flowmetry and other useful methods |
| 18th of June 13:00 | |
| Lecture 23 | Brain Biochemistry: . Monitoring of cerebral tissue oxygenation: SJVO2, Licox, and NIRS. Cerebral microdialysis. |
| Lecture 24 | Alternative indices of cerebrovascular reactivity: use of Near Infrared Spectropscopy, tissue oxygenation and others |
| 19th of June 13:00 | |
| Lecture 25 | Modelling of cerebral blood flow: Integration of cerebral blood flow into Marmarou’s model |
| Lecture 26 | Experimental cerebrovascular dynamics: Projects, instrumentation, models. |
| 25th of June 13:00 | |
| Lecture 27 | Software for brain monitoring: ICM+ |
| Lecture 28 | Overview of techniques for brain signal analysis. |
| 25th of June 13:00 | |
| Lecture 29 | The Quiz |
Prof Marek Czosnyka and Dr Peter Smielewski
University of Cambridge
Division of Neurosurgery
Department of Clinical Neurosciences
email (Marek): mc141@medschl.cam.ac.uk
email (Peter): ps10011@cam.ac.uk
