ReviewAJNR. American journal of neuroradiology2023
The Monro-Kellie Doctrine: A Review and Call for Revision.
Review in AJNR. American journal of neuroradiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07786324 (Comparison of 3% Hypertonic Saline Versus 20% Mannitol in Reduction of Increased Intracranial Pressure in Patients With Traumatic Brain Injury Using Optic Nerve Sheath Diameter Measurements''), which is not on this map. Cited by 49 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of 3% Hypertonic Saline Versus 20% Mannitol in Reduction of Increased Intracranial Pressure in Patients With Traumatic Brain Injury Using Optic Nerve Sheath Diameter Measurements''
Who cites it
49 citing papers in PubMed.
- Noninvasive 3D mapping of tissue stress using reverberant shear wave.Nature communications · 2026Article
- Response to Comment on "Evaluation of Intracranial Pressure in Patients with Severe Brain Injury Using Contrast-Enhanced Ultrasound: A Pilot Study with Preliminary Findings".Neurocritical care · 2026Article
- Time-resolved laser speckle contrast imaging (TR-LSCI) of cerebral blood flow response to intracranial pressure elevation.Journal of biomedical optics · 2026Article
- Hydrocephalus-associated persistent pain: a preclinical investigation correlating brain fluid imbalance and sensory alterations.Fluids and barriers of the CNS · 2026Article
- Review
- Predicting brain volumes from anthropometric and demographic features: insights from UK biobank neuroimaging data.Brain structure & function · 2026Article
- Article
- Time-Resolved Laser Speckle Contrast Imaging (TR-LSCI) of Cerebral Blood Flow Response to Intracranial Pressure Elevation.bioRxiv : the preprint server for biology · 2026Article
- Local metastatic expansion versus secondary intra-organ dissemination: two causes of neurological death explained by fundamentally different metastatic colonization patterns.Molecular cancer · 2026Article
- Arterial-related craniospinal physiological compliance assessed by phase-contrast MRI and lumbar infusion test.Brain communications · 2026Article
- Longitudinal MRI-based changes in intracranial volume and skull thickness observed in both metachromatic leukodystrophy and multiple sclerosis.NeuroImage. Clinical · 2026Article
- Idiopathic CSF dynamic disturbances causing headache: a narrative review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Human cerebrospinal fluid net flow enhanced by respiration during the awake state.Nature communications · 2025Article
- A mechanistic approach for intracranial pressure (ICP) level estimation.Scientific reports · 2025Article
- Novel and classic imaging signs of increased intracranial pressure.Neuroradiology · 2025Article
- Incidence of temporal thumb sign in adult patients with idiopathic seizures with and without elevated opening cerebrospinal fluid pressure.European radiology · 2025Article
- External Ventricular Drain Column Height Fails to Explain Cerebrospinal Fluid Drainage Volumes.Nursing in critical care · 2025Observational
- Are we still overlooking some important structural changes at the basal surface of the brain in epilepsy imaging?European radiology · 2025Article
- "Talk and die" syndrome, a tragedy in traumatic brain injury: a cohort study.Journal of medical case reports · 2025Article
- Multimodal nomogram integrating deep learning radiomics and hemodynamic parameters for early prediction of post-craniotomy intracranial hypertension.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.