• B Schaller and R Graf.
• Max Planck Institute for Neurological Research, Cologne, Germany.
• J Trauma. 2005 Dec 1; 59 (6): 1521-31.

BackgroundThe 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.MethodsReview from the literature.ResultsThe 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.ConclusionThis 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.

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