{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:19:42Z","timestamp":1790363982749,"version":"4.1.0"},"reference-count":44,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:p>\n                    The Monro-Kellie doctrine describes the principle of homeostatic intracerebral volume regulation, which stipulates that the total volume of the parenchyma, cerebrospinal fluid, and blood remains constant. Hypothetically, a slow shift (e.g., brain edema development) in the irregular vasomotion-driven exchanges of these compartmental volumes may lead to increased intracranial hypertension. To evaluate this paradigm in a clinical setting and measure the processes involved in the regulation of systemic intracranial volume, we quantified cerebral blood flow velocity (CBFv) in the middle cerebral artery, arterial blood pressure (ABP), and intracranial pressure (ICP), in 238 brain-injured subjects. Relative changes in compartmental compliances\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>a<\/jats:sub>\n                    <\/jats:italic>\n                    (arterial) and\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>i<\/jats:sub>\n                    <\/jats:italic>\n                    (combined venous and CSF compartments) were mathematically estimated using these raw signals through time series analysis;\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>a<\/jats:sub>\n                    <\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>i<\/jats:sub>\n                    <\/jats:italic>\n                    were used to compute an index of cerebral compliance (ICC) as a moving correlation coefficient between\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>a<\/jats:sub>\n                    <\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>i<\/jats:sub>\n                    <\/jats:italic>\n                    . Conceptually, a negative ICC would represent a functional Monro-Kellie doctrine by illustrating volumetric compensations between\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>a<\/jats:sub>\n                    <\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">\n                      C\n                      <jats:sub>i<\/jats:sub>\n                    <\/jats:italic>\n                    . Clinical observations show that Lundberg A-waves and arterial hypertension were associated with negative ICC, whereas in refractory intracranial hypertension, a positive ICC was observed. In subjects who died, ICC was significantly greater than in survivors (0.46\u00b10.027 versus 0.22\u00b10.017;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt;0.01) over the first 5 days of intensive care. The mortality rate is 5% when ICC is less than 0, and 43% when above 0.7. ICC above 0.7 was associated with terminally elevated ICP (chi-square\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    =0.026). We propose that the Monro-Kellie doctrine can be monitored in real time to illustrate the state of intracranial volume regulation.\n                  <\/jats:p>","DOI":"10.1089\/neu.2011.2018","type":"journal-article","created":{"date-parts":[[2011,9,6]],"date-time":"2011-09-06T14:41:49Z","timestamp":1315320109000},"page":"1354-1363","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":64,"title":["Continuous Monitoring of the Monro-Kellie Doctrine: Is It Possible?"],"prefix":"10.1177","volume":"29","author":[{"given":"Dong-Joo","family":"Kim","sequence":"first","affiliation":[{"name":"University of Cambridge","place":["United Kingdom"]},{"name":"University of Toronto"},{"name":"Korea University","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zofia","family":"Czosnyka","sequence":"additional","affiliation":[{"name":"University of Cambridge","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Kasprowicz","sequence":"additional","affiliation":[{"name":"Wroclaw University of Technology","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Smieleweski","sequence":"additional","affiliation":[{"name":"University of Cambridge","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Baledent","sequence":"additional","affiliation":[{"name":"Amiens University Hospital","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marie","family":"Guerguerian","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Pickard","sequence":"additional","affiliation":[{"name":"University of Cambridge","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Czosnyka","sequence":"additional","affiliation":[{"name":"University of Cambridge","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,5,1]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2005.103.1.0046"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.42.8.687"},{"key":"e_1_3_3_4_1","unstructured":"Avezaat C.J. van Eijndhoven J.H. 1984. 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