Cerebral Blood Flow and Oxygen Supply in the Brain

Intracranial dynamics concerns the physical and chemical interactions of cerebral vasculature, cerebrospinal fluid (CSF) and the brain tissue. Despite ever more accurate and detailed imaging modalities, fluid and momentum exchange between blood and CSF is poorly understood. To answer questions about key metabolic functions of the brain, we harness predictive mathematical models informed by three-dimensional dynamic imaging data. This lecture will survey current knowledge of cerebral blood flow and CSF dynamics including natural CSF flow patterns and mixing phenomena of solute in CSF. A theory of CSF flow will be shown to explain the causes of brain disease and point to strategies for effective drug delivery to the central nervous system. In addition, novel hypotheses for microcirculatory water exchange will be presented. These new insights on cerebral fluid clearance and perivascular fluid transport may hold the key to understanding and treating several pathologies including brain edema, hydrocephalus and Alzheimer’s disease.