The Monro-Kellie doctrine for intracranial pressure

doi:10.3969/j.issn.1672-6731.2020.07.004

Abstract

Abstract:

This laymen type of scientific history writing summarized the creation and development of Monro-Kellie doctrine and its potential role in intracranial hypertension. A Scottish scholar Monro created the concept of "intracranial pressure (ICP)" and his student Kellie supplemented Monro's concept, suggesting both cranial content and blood contributed to the ICP. Another Scottish scholar Abercrombie also studied ICP and in 1828 first used the term "Monro-Kellie doctrine". After establish the existence of cerebrospinal fluid, Burrows complemented further of the Monro-Kellie doctrine with cerebrospinal fluid. Over the last 200 years, the concept of ICP was recognized by physicians and used in clinical management of cranial disorders.

Key words: Intracranial pressure, Cerebrospinal fluid, History of medicine, Review

摘要：

回顾Monro-Kellie法则的产生及其对颅内压病理生理学研究的历史进程。Monro首先提出“颅内压”概念，Kellie指出颅内压与颅内容量的关系，认为脑血流量与脑实质共同影响颅内压，Abercrombie则验证颅内压与脑血流量保持恒定的关系，并于1828年正式确立“Monro-Kellie法则”。由于Magendie发现脑脊液的存在，Burrows将脑脊液引入颅内压的范畴，进一步完善Monro-Kellie法则。此后Monro-Kellie法则用于解释颅内压病理生理改变并不断证实其合理性。Leyden在动物实验中首次报告颅内高压的致死性作用，Spenser在临床病例中证实颅内压增高致呼吸停止，Quincke发明腰椎穿刺测量脑脊液压力的方法，Kocher首次采用去骨辨减压术降低颅内压，直至Cushing提出“Cushing三主征”，即脑容量、脑脊液容量和脑血容量的总和恒定，将Monro-Kellie法则进一步定量化。至此Monro-Kellie法则不断得到证实和完善，Lundberg里程碑式发明脑室内颅内压床旁监测装置，Mark强调脑静脉血对颅内压的影响。近200年来Monro-Kellie法则的演进史如同一盏盏路灯指引着读者的思维沿着神经科学的发展轨迹由远及今。

关键词: 颅内压, 脑脊髓液, 医学史, 综述

ZHANG John. The Monro-Kellie doctrine for intracranial pressure[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(7): 580-584.

张和. 颅内压的Monro-Kellie法则[J]. 中国现代神经疾病杂志, 2020, 20(7): 580-584.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2020.07.004

https://journal11.magtechjournal.com/cjcnn/EN/Y2020/V20/I7/580

References

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