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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 ...
An increase in pressure, most commonly due to head injury leading to intracranial hematoma or cerebral edema, can crush brain tissue, shift brain structures, contribute to hydrocephalus, cause brain herniation, and restrict blood supply to the brain. [13] It is a cause of reflex bradycardia. [14]
In herniation syndrome, which is indicative of brain herniation, decorticate posturing occurs, and, if the condition is left untreated, develops into decerebrate posturing. [12] Posturing has also been displayed by patients with Creutzfeldt–Jakob disease, [13] diffuse cerebral hypoxia, [14] and brain abscesses. [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.
Younger children are more likely to have a more rapid neurological degeneration with profound brainstem dysfunction over several days. [ citation needed ] Headache is the most common symptom in those with Chiari malformation type 1 (in which only the cerebellar tonsils descend below the foramen magnum).
Children: In older children, the fontanelles are closed, so there is no visible change in head size. [7] Since there is limited expansion of the skull, symptoms are more representative of the effects of increased intracranial pressure on a child's developing brain. [10]
Early infantile epileptic encephalopathy (acquired or congenital abnormal cortical development). Early myoclonic epileptic encephalopathy (possibly due to metabolic disorders). Gluten encephalopathy: Focal abnormalities of the white matter (generally area of low perfusion) are appreciated through magnetic resonance. Migraine is the most common ...
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]