ReviewCritical care (London, England)2025
Monro-Kellie 4.0: moving from intracranial pressure to intracranial dynamics.
Review in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed.
- Effects of systemic mild hypercapnia on brain function in a refractory cardiac arrest model treated with extracorporeal cardiopulmonary resuscitation.Resuscitation plus · 2026Article
- Intracranial pressure physiology, monitoring and individualized management in the acute brain injured patient.Intensive care medicine · 2026Review
- Intracranial Pressure Estimation Using B4C Device: A Systematic Review on the Validation Studies.Neurocritical care · 2026Review
- 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
- Clinical characteristics of late-onset adult autoimmune glial fibrillary acidic protein astrocytopathy: a retrospective cohort study.Journal of neurology · 2026Article
- Invasive Cerebral Oximetry: What Can Go Wrong? Seven Pitfalls you should know.Neurocritical care · 2026Article
- Surgical Management of Traumatic Brain Injury Based on Intracranial Compliance: Toward Personalized Decision-Making.Brain sciences · 2026Review
- Review
- Neuroworsening in traumatic brain injury: A consensus of the Latin American Brain Injury Consortium (LABIC) and the Latin American Federation of Neurosurgical Societies (FLANC) expert group.Neurosurgical review · 2026Article
- Autoregulation-guided intracranial pressure and cerebral perfusion pressure targets in different subtypes and characteristics of traumatic brain injury.Critical care (London, England) · 2026Observational
- Intracranial pressure management in severe intraventricular hemorrhage: A minireview.World journal of critical care medicine · 2026Review
- Multimodal Monitoring in Eclamptic Intracerebral Hemorrhage Complicated by Reversible Cerebral Vasoconstriction Syndrome (RCVS): A Case Report.Case reports in critical care · 2026Article
- The clinical significance of intracranial pressure waveform analysis in brain-injured patients.Critical care science · 2026Review
- Arterial-related craniospinal physiological compliance assessed by phase-contrast MRI and lumbar infusion test.Brain communications · 2026Article
- Exploring Cerebrospinal Compensatory Zones Using a Noninvasive Approach.Neurocritical care · 2025Observational
- First Breath Matters: Out-of-Hospital Mechanical Ventilation in Patients with Traumatic Brain Injury.Journal of clinical medicine · 2025Review
- Mind the drain: expanding TIMING-ICP discussion.Critical care (London, England) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Monro-Kellie doctrine, introduced in the late 18th century, was a groundbreaking concept aimed at explaining the interactions between intracranial volume components. It has since become a cornerstone of brain physiology, now recognized as intracranial dynamics. Initially, the doctrine focused on physiological observations of the three incompressible components of the cranial vault: brain tissue, blood, and cerebrospinal fluid (CSF). Over the centuries, advancements in neuroscience and medical technology have deepened our understanding of intracranial pressure (ICP) regulation, its pathophysiological implications and its role in neurological disorders. This revisitation of the Monro-Kellie doctrine examines how impairments in cerebrovascular autoregulation, brain compartmentalization and the glymphatic system interact in severely brain-injured patients, calling for new management strategies when facing these critical situations. Additionally, it reinforces the need for a holistic monitoring approach to improve early diagnostics and intervention. The evolution of ICP assessment has significantly shaped the management of brain trauma, spontaneous bleeding, ischemic stroke, and hydrocephalus. With the introduction of innovative tools such as brain ultrasound, automated pupillometry and noninvasive pressure waveform monitoring, ICP management is shifting toward more accessible and continuous evaluation strategies. This review explores how blending historical principles with cutting-edge innovations is transforming neuromonitoring and enhancing patient outcomes in critical care.
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Registered trials
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.