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Uncal herniation can be suggested on CT, however, MRI is the gold standard. Features of unilateral descending tentorial herniation include: medial displacement of the uncus and parahippocampal gyrus of the temporal lobe. medial displacement of the temporal horn of the lateral ventricle.
There are a number of different patterns of brain herniation that describe the type of herniation occurring: subfalcine herniation. transalar herniation: ascending and descending. transtentorial herniation. downward: uncal herniation and central herniation. upward: ascending transtentorial herniation. tonsillar herniation.
On CT it is usually possible to show the mass effect of a tumor on the brainstem, but identification of an uncal herniation is much harder with CT. MRI T2-weighted images may show leucomalacic changes on the affected cerebral peduncle 4 .
Transtentorial herniation is a type of cerebral herniation that occurs due to mass effect and can be life-threatening.
Subfalcine herniation, also known as midline shift or cingulate hernia, is the most common type of cerebral herniation. It is generally caused by unilateral frontal, parietal or temporal lobe disease that pushes ipsilateral cingulate gyrus beneath the free edge of the falx cerebri to the opposite side due to raised intracranial pressure 4.
The uncus is also featured in the term uncal herniation (downward transtentorial herniation of the uncus). History and etymology. Uncus is Latin for "hook", referencing its shape.
Tonsillar herniation is a type of brain herniation characterized by the inferior descent of the cerebellar tonsils below the foramen magnum 5. Clinically, the presence of tonsillar herniation is often called coning. The terminology of caudally displaced tonsils is discussed in the article on cerebellar tonsillar ectopia.
Uncal herniation is a subtype of transtentorial downward brain herniation that involves the uncus, usually related to cerebral mass effect increasing the intracranial pressure. Clinical presentation pupils and globe clinical features 3 initial...
Transtentorial herniation is a type of cerebral herniation broadly divided into two major types based on the direction of herniation: downwards due to supratentorial mass effect and upward due to infratentorial mass effect.
Duret hemorrhages are small, usually multiple, hemorrhages in the midbrain or pons resulting from rapidly developing brain herniation, especially central herniation. They generally have a dismal prognosis.