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Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull. The brain can shift across such structures as the falx cerebri , the tentorium cerebelli , and even through the foramen magnum (the hole in the base of the skull through ...
One case of hydrocephalus was a man whose brain shrank to a thin sheet of tissue, due to a buildup of cerebrospinal fluid in his skull. As a child, the man had a shunt, but it was removed when he was 14. In July 2007, at age 44, he went to a hospital due to mild weakness in his left leg.
Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people. [ 1 ] [ 2 ] Overall, closed-head injuries and other forms of mild traumatic brain injury account for about 75% of the estimated 1.7 million brain injuries that occur ...
Children, however, may experience head injuries from accidental falls or intentional causes (such as being struck or shaken) leading to hospitalization. [1] Acquired brain injury (ABI) is a term used to differentiate brain injuries occurring after birth from injury, from a genetic disorder, or from a congenital disorder. [2]
Types of brain herniation [21] 1) Uncal 2) Central - The brainstem herniates caudally. 3) Cingulate herniation - The brain squeezes under the falx cerebri. 4) Transcalvarial herniation - through a skull fracture 5) Upward herniation of the cerebellum 6) Tonsillar herniation - the cerebellar tonsils herniate through the foramen magnum.
This results in increased cerebral blood volume, which increases ICP, lowering CPP further and causing a vicious cycle. This results in widespread reduction in cerebral flow and perfusion, eventually leading to ischemia and brain infarction. Increased blood pressure can also make intracranial hemorrhages bleed faster, also increasing ICP.
Brain herniation is associated with hyperventilation, extensor rigidity, pupillary asymmetry, pyramidal signs, coma and death. [10] Hemorrhage into the basal ganglia or thalamus causes contralateral hemiplegia due to damage to the internal capsule. [7] Other possible symptoms include gaze palsies or hemisensory loss. [7]
Prognosis is very poor when IVH results from intracerebral hemorrhage related to high blood pressure and is even worse when hydrocephalus follows. [1] It can result in dangerous increases in ICP and can cause potentially fatal brain herniation. [1] Even independently, IVH can cause morbidity and mortality.