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Kernohan's notch is a cerebral peduncle indentation associated with some forms of transtentorial herniation (uncal herniation). [1] [2] It is a secondary condition caused by a primary injury on the opposite hemisphere of the brain. [3]
Treatment involves removal of the etiologic mass and decompressive craniectomy. Brain herniation can cause severe disability or death. In fact, when herniation is visible on a CT scan, the prognosis for a meaningful recovery of neurological function is poor. [2]
This is called herniation and will often cause an enlarged pupil on the affected side, due to pressure on the oculomotor nerve. Tentorial herniation is a serious symptom, especially since the brainstem is likely to be compressed as well if the intracranial pressure rises further. A common type of herniation is uncal herniation.
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.
The treatment of cerebral edema depends on the cause and includes monitoring of the person's airway and intracranial pressure, proper positioning, controlled hyperventilation, medications, fluid management, steroids. [3] [7] [8] Extensive cerebral edema can also be treated surgically with a decompressive craniectomy. [7]
Treatment involves replacing or flushing the shunt to address the cause of the obstruction and restore flow through the catheter. [ 66 ] The rate of initial shunt infection ranges from 3.6 to 12.6% [ 9 ] The signs and symptoms of shunt infection are variable, but the most common include headache, nausea, fever, swelling, and lethargy.
Microdiscectomy (or microdecompression) is a minimally invasive surgical procedure in which a portion of a herniated nucleus pulposus is removed by way of a surgical instrument. [2] The purpose of this procedure is to relieve the pressure and reduce the local inflammatory reaction around a nerve root, caused by the herniated nucleus pulposus.
Because a patient may have a lucid interval, any significant head trauma is regarded as a medical emergency and receives emergency medical treatment even if the patient is conscious. Delayed cerebral edema , a very serious and potentially fatal condition in which the brain swells dramatically, may follow a lucid interval that occurs after a ...