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In uncal herniation, a common subtype of transtentorial herniation, the innermost part of the temporal lobe, the uncus, can be squeezed so much that it moves towards the tentorium and puts pressure on the brainstem, most notably the midbrain. [8] The tentorium is a structure within the skull formed by the dura mater of the meninges.
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]
Duret haemorrhages are haemorrhages secondary to raised intracranial pressure with formation of a transtentorial pressure cone involving the front part of the cerebral peduncles, the cerebral crura. Increased pressure above the tentorium may also involve other midbrain structures. [citation needed]
Shows six types of brain herniation: Supratentorial herniation; Uncal; Central (transtentorial) Cingulate (subfalcine) Transcalvarial; Infratentorial herniation; Upward (upward cerebellar or upward transtentorial) Tonsillar (downward cerebellar) Date: 3/5/08: Source
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.
Brain herniation types.svg licensed with Cc-by-sa-3.0, Cc-by-sa-3.0-migrated, GFDL 2009-09-16T11:27:51Z RupertMillard 619x684 (379260 Bytes) Reverted to version as of 21:08, 5 March 2008 - better to replace with new image to avoid breaks
The tentorial notch is located between the tentorial edges and communicates the supratentorial and infratentorial spaces. This area can be divided into three spaces: anterior, middle (lateral to), and posterior to the brainstem.
Delayed surgery can result in permanent brain damage or death. Without surgery, death usually follows, due to enlargement of the hematoma, causing a brain herniation. [3] As with other types of intracranial hematomas, the blood almost always must be removed surgically to reduce the pressure on the brain. [9]