Brain herniation syndromes

Types

Type of brain herniation

1. Uncal
   • blown pupil
   • hemiparesis/babinski (75% contralateral)
2. Central Transtentorial
   • pinpoint → nonresponsive midpoint pupils
   • motor weakness → increased tone → flexor, then extensor posturing
3. Cerebellotonsilar
   • pinpoint pupils
   • sudden respiratory and cardiovascular collapse
   • flaccid quadriplegia
4. Upward Transtentorial
   • pinpoint pupils
   • downward conjugate gaze

See Also

• Elevated intracranial pressure
• Head trauma (main)
• Intracranial hemorrhage (main)