The Monro-Kellie hypothesis: applications in CSF volume depletion

Area of Science:

• Neurology
• Neurosurgery
• Medical Physics

Background:

• The Monro-Kellie doctrine, originating from Monro and Kellie's work, posits a constant intracranial volume.
• It suggests that an increase in one intracranial component necessitates a decrease in others.

Purpose of the Study:

• To explore the theoretical implications of the Monro-Kellie doctrine.
• To correlate the doctrine with observed MRI abnormalities in intracranial hypotension.

Main Methods:

• Historical review of the Monro-Kellie hypothesis.
• Analysis of MRI findings in patients with intracranial hypotension.

Main Results:

• The Monro-Kellie hypothesis provides a framework for understanding intracranial pressure dynamics.
• MRI findings such as meningeal enhancement and subdural collections align with the doctrine's principles.
• Cerebral venous sinus engorgement and pituitary enlargement are also explained by this hypothesis.

Conclusions:

• The Monro-Kellie doctrine remains a fundamental concept in neurocritical care.
• It effectively explains various MRI abnormalities associated with decreased cerebrospinal fluid (CSF) volume and intracranial hypotension.