From the Departments of Radiology (J.C.B., A.A.M., D.R.J., C.M.C.)
From the Departments of Radiology (J.C.B., A.A.M., D.R.J., C.M.C.).
AJNR Am J Neuroradiol. 2023 Jan;44(1):2-6. doi: 10.3174/ajnr.A7721. Epub 2022 Dec 1.
The Monro-Kellie doctrine is a well-accepted principle of intracranial hemodynamics. It has undergone few consequential revisions since it was established. Its principle is straightforward: The combined volume of neuronal tissue, blood, and CSF is constant. To maintain homeostatic intracranial pressure, any increase or decrease in one of these elements leads to a reciprocal and opposite change in the others. The Monro-Kellie doctrine assumes a rigid, unadaptable calvaria. Recent studies have disproven this assumption. The skull expands and grows in response to pathologic changes in intracranial pressure. In this review, we outline what is known about calvarial changes in the setting of pressure dysregulation and suggest a revision to the Monro-Kellie doctrine that includes an adaptable skull as a fourth component.
Monro-Kellie 定律是被广泛接受的颅内血液动力学原则。自确立以来，该原则很少进行重大修订。其原理很简单：神经元组织、血液和 CSF 的总容量是恒定的。为了维持颅内压的动态平衡，这些元素中的任何一个增加或减少都会导致其他元素相应地、相反地变化。Monro-Kellie 定律假设颅骨是刚性的、不可适应的。最近的研究推翻了这一假设。颅骨会随着颅内压的病理变化而扩张和生长。在这篇综述中，我们概述了在压力调节紊乱情况下颅骨变化的已知情况，并提出了对包括可适应颅骨在内的 Monro-Kellie 定律的修正。
