B Schaller1, R Graf. 1. Max Planck Institute for Neurological Research, Cologne, Germany.
Abstract
BACKGROUND: The classical "Kellie-Monroe" doctrine considering the intracranial volume to be a closed system that is confined within the nearly rigid skull, conserves different mass, and has equal vascular inflow and outflow. Several experimental and clinical studies have given evidence that this is not entirely true from the (patho)physiologic point of view, even so our understanding of this phenomenon is incomplete. METHODS: Review from the literature. RESULTS: The present literature review revokes this classical doctrine and suggests a more differentiated description for the dynamic of intracranial pressure (ICP): instead of the previously suggested lumped-parameter models, the authors describe different intracranial compartments that are related to different brain regions. CONCLUSION: This has the advantage of great practical use on the one hand and allows the demonstration of relevant intercompartimental intracranial pressure differences. In addition, these ICP differences can be revealed to different ICP compartments and to its relationship to CBF. Special reference is given to determine appropriate forms for the nonconstant resistance and compliance parameters.
BACKGROUND: The classical "Kellie-Monroe" doctrine considering the intracranial volume to be a closed system that is confined within the nearly rigid skull, conserves different mass, and has equal vascular inflow and outflow. Several experimental and clinical studies have given evidence that this is not entirely true from the (patho)physiologic point of view, even so our understanding of this phenomenon is incomplete. METHODS: Review from the literature. RESULTS: The present literature review revokes this classical doctrine and suggests a more differentiated description for the dynamic of intracranial pressure (ICP): instead of the previously suggested lumped-parameter models, the authors describe different intracranial compartments that are related to different brain regions. CONCLUSION: This has the advantage of great practical use on the one hand and allows the demonstration of relevant intercompartimental intracranial pressure differences. In addition, these ICP differences can be revealed to different ICP compartments and to its relationship to CBF. Special reference is given to determine appropriate forms for the nonconstant resistance and compliance parameters.
Authors: Thomas Lescot; Vincent Reina; Yannick Le Manach; Filippo Boroli; Dorian Chauvet; Anne-Laure Boch; Louis Puybasset Journal: Intensive Care Med Date: 2011-02-26 Impact factor: 17.440
Authors: M Hupp; N Pfender; K Vallotton; J Rosner; S Friedl; C M Zipser; R Sutter; M Klarhöfer; J M Spirig; M Betz; M Schubert; P Freund; M Farshad; A Curt Journal: AJNR Am J Neuroradiol Date: 2021-02-04 Impact factor: 3.825