A comprehensive Cerebrovascular Simulation Model for Teaching and Research

The mathematical relationships between cerebral perfusion pressure (CPP), intracranial pressure (ICP) and cerebral blood flow (CBF) as well as the autoregulatory control of these quantities by the normal brain, have been well described [1]. However, the alterations occurring in these quantities in pathological conditions and their complex non-linear relations are difficult to be understood in simple qualitative terms; for this reason, their analysis can benefit from the use of mathematical models. In past years, we developed a comprehensive mathematical model of the cerebral circulation, which included many different aspects of patho-physiological relevance: cerebral autoregulation, cerebrospinal fluid (CSF) circulation, CO2 reactivity, intracranial compliance, ICP dynamics and venous collapsibility. With that model, we were able to simulate several physiological phenomena and clinical results on head injured patients [2]. Results show that the model is able to simulate autoregulation to arterial pressure changes and CO2 reactivity very well, and to predict intracranial instability (plateau waves) in patients with reduced intracranial elasticity and reduced CSF outflow. Moreover, the model is able to reproduce the measured time pattern of middle cerebral artery velocity and ICP in different head injured patient