Monitoring Intracranial Pressure



The cranium is uniquely intolerant to changes in volume. The classical thinking of the relationship between components of the cranium and the pressure created by their presence is defined by the Monroe Kellie Doctrine [1]. Under normal physiologic conditions tissue cells, blood, and cerebrospinal fluid (CSF) maintain a consistent presence within the cranium and spinal cord areas. When any single component increases, the other two have a limited capacity to accommodate by shifting into accessory spaces so as to avoid a rise in intracranial pressure (ICP) and thus maintain stable cerebral perfusion pressure (CPP).


Intracranial pressure monitoring Parenchymal devices Cerebral pressure reactivity Intraventricular catheter Coagulopathy Herniation Monro-Kellie hypothesis 


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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Anesthesiology and Perioperative MedicineOregon Health and Science UniversityPortlandUSA

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