Brain herniation syndromes: Difference between revisions

Latest revision as of 23:44, 1 October 2019

Type of brain herniation

Uncal
- Blown pupil (third nerve palsy, compression from uncus into tentorium cerebelli
- Hemiparesis/babinski (75% contralateral)
Central Transtentorial
- Pinpoint → nonresponsive midpoint pupils
- Motor weakness → increased tone → flexor, then extensor posturing
Cerebellotonsilar (posterior fossa pressure)
- Pinpoint pupils
- Sudden respiratory and cardiovascular collapse
- Flaccid quadriplegia
Upward Transtentorial
- Pinpoint pupils
- Downward conjugate gaze
Subfalcine herniation (cerebral mass lesion causes medial surface of affected hemisphere to push against rigid falx cerebri, then herniate underneath)
- Cingulate gyrus most commonly affected
- Often clinically silent

Authors:

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 [[File:Brain herniation.png|thumbnail|Type of brain herniation]]
 #Uncal
-#*blown pupil
+#*Blown pupil ([[third nerve palsy]], compression from uncus into tentorium cerebelli
-#*hemiparesis/babinski (75% contralat)
+#*[[weakness|Hemiparesis]]/babinski (75% contralateral)
 #Central Transtentorial
-#*B pinpoint → nonresponsive midpoint
+#*Pinpoint → nonresponsive midpoint pupils
-#*B motor weakness/inc tone
+#*Motor [[weakness]]  → increased tone  → flexor, then extensor posturing
-#Cerebellotonsilar
+#Cerebellotonsilar (posterior fossa pressure)
-#*B pinpoint
+#*Pinpoint pupils
-#*sudden cario/resp colapse
+#*Sudden [[respiratory failure|respiratory]] and [[shock|cardiovascular collapse]]
-#*flacid quadraplegia
+#*Flaccid [[weakness|quadriplegia]]
 #Upward Transtentorial
-#*B pinpoint
+#*Pinpoint pupils
-#*downward conjugate gaze
+#*Downward conjugate gaze
+#Subfalcine herniation (cerebral mass lesion causes medial surface of affected hemisphere to push against rigid falx cerebri, then herniate underneath)
+#*Cingulate gyrus most commonly affected
+#*Often clinically silent
 ==See Also==
+*[[Elevated intracranial pressure]]
+*[[Head trauma (main)]]
 *[[Intracranial hemorrhage (main)]]