Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulation
The so-called Monro-Kellie doctrine states that with an intact skull, the sum of the volume of the brain plus the cerebrospinal fluid volume plus the intracranial blood volume is constant. Therefore an increase in one should cause a reduction in one or both of the remaining two. The researcher who e...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2014-12-01
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| Series: | Veins and Lymphatics |
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| Online Access: | http://www.pagepressjournals.org/index.php/vl/article/view/4682 |
| _version_ | 1818118698618060800 |
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| author | Pasquale De Bonis Carmelo Anile |
| author_facet | Pasquale De Bonis Carmelo Anile |
| author_sort | Pasquale De Bonis |
| collection | DOAJ |
| description | The so-called Monro-Kellie doctrine states that with an intact skull, the sum of the volume of the brain plus the cerebrospinal fluid volume plus the intracranial blood volume is constant. Therefore an increase in one should cause a reduction in one or both of the remaining two. The researcher who expressed the doctrine in such a way was indeed Harvey Cushing in 1925, during a lecture in Edinburgh. The original Monro-Kellie doctrine is the result of observations on autopsies and several animal experiments. What the original doctrine states is a dynamic explanation of the intracranial system, aimed at explaining how a pulsatile and continuous perfusion may occur in a closed-non-expandable and fully filled system. During each cardiac cycle the quantity of blood within the head must be the same: during the systole, the brain arteries dilate, and, in the mean time, a quantity of blood, equal to that which is dilating them, is passing out of the head through the veins. During the succeeding diastole, the quantity which dilated the brain arteries passes into the corresponding veins and, at the same time, as much passes from the sinuses out of the head, as enters into the head from the arteries situated between the heart and the head. Monro implicitly states that the blood coming out from the cerebral veins into the sinuses must be pulsatile and (almost) synchronous with the arteries. That is deeply different from the concept of a constant content of a <em>rigid</em> <em>case</em>, as expressed by Cushing. |
| first_indexed | 2024-12-11T04:58:27Z |
| format | Article |
| id | doaj.art-91ce05b08b4d47aaaac24b8abe1eab78 |
| institution | Directory Open Access Journal |
| issn | 2279-7483 |
| language | English |
| last_indexed | 2024-12-11T04:58:27Z |
| publishDate | 2014-12-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Veins and Lymphatics |
| spelling | doaj.art-91ce05b08b4d47aaaac24b8abe1eab782022-12-22T01:20:14ZengPAGEPress PublicationsVeins and Lymphatics2279-74832014-12-013310.4081/vl.2014.46824047Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulationPasquale De Bonis0Carmelo Anile1Neurosurgery, S. Anna University Hospital, Cona di Ferrara (FE)Neurosurgery, Catholic University School of Medicine, RomeThe so-called Monro-Kellie doctrine states that with an intact skull, the sum of the volume of the brain plus the cerebrospinal fluid volume plus the intracranial blood volume is constant. Therefore an increase in one should cause a reduction in one or both of the remaining two. The researcher who expressed the doctrine in such a way was indeed Harvey Cushing in 1925, during a lecture in Edinburgh. The original Monro-Kellie doctrine is the result of observations on autopsies and several animal experiments. What the original doctrine states is a dynamic explanation of the intracranial system, aimed at explaining how a pulsatile and continuous perfusion may occur in a closed-non-expandable and fully filled system. During each cardiac cycle the quantity of blood within the head must be the same: during the systole, the brain arteries dilate, and, in the mean time, a quantity of blood, equal to that which is dilating them, is passing out of the head through the veins. During the succeeding diastole, the quantity which dilated the brain arteries passes into the corresponding veins and, at the same time, as much passes from the sinuses out of the head, as enters into the head from the arteries situated between the heart and the head. Monro implicitly states that the blood coming out from the cerebral veins into the sinuses must be pulsatile and (almost) synchronous with the arteries. That is deeply different from the concept of a constant content of a <em>rigid</em> <em>case</em>, as expressed by Cushing.http://www.pagepressjournals.org/index.php/vl/article/view/4682Monro-Kellie doctrine, intracranial system, cerebral blood flow, cerebral autoregulation, intracranial veins. |
| spellingShingle | Pasquale De Bonis Carmelo Anile Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulation Veins and Lymphatics Monro-Kellie doctrine, intracranial system, cerebral blood flow, cerebral autoregulation, intracranial veins. |
| title | Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulation |
| title_full | Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulation |
| title_fullStr | Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulation |
| title_full_unstemmed | Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulation |
| title_short | Storms, hanged pirates, anemia, exsanguination: the contributions of Monro, Kellie and Abercrombie in understanding intracranial blood circulation |
| title_sort | storms hanged pirates anemia exsanguination the contributions of monro kellie and abercrombie in understanding intracranial blood circulation |
| topic | Monro-Kellie doctrine, intracranial system, cerebral blood flow, cerebral autoregulation, intracranial veins. |
| url | http://www.pagepressjournals.org/index.php/vl/article/view/4682 |
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