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In 1783, Scottish physician Alexander Monro secundus (1733-1817) deduced that the cranium was "a rigid box" of unchanging size containing three things - brain, blood and cerebrospinal fluid. He therefore proposed that any addition to the intra-cranial compartment must push something else out or increase intracranial pressure.

Monro's thesis was supported by George Kellie (1758-1829), who dissected the bodies of 3 men who died at sea and subsequently washed up near the Leith docks in Edinburgh on the morning of the 4th of November, 1821.

The Monro-Kellie doctrine, also known as the Monro-Kellie hypothesis, provides the physiological basis for common treatments of raised intracranial pressure. These include opening the skull, using diuretics such as Mannitol to remove water and encouraging patients to hyperventilate to reduce blood carbon dioxide and constrict blood vessels.


And you thought neurosurgery was complicated.


Neurosurgical Intensive Care Unit, USC LA - http://uscneurosurgery.com/infonet/5036.htm
G. Kellie An account of the appearances observed in the dissection of two of the three individuals presumed to have perished in the storm of the 3rd, and whose bodies were discovered in the vicinity of Leith on the morning of the 4th November 1821 with some reflections on the pathology of the brain. The Transactions of the Medico-Chirurgical Society of Edinburgh, 1824, 1: 84-169

Submitted with trepidation to : UshdfgakjasghHatesYouQuest 2008

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