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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 ...
Patients may have a history of loss of consciousness but they recover and do not relapse. Clinical onset occurs over hours. Complications include focal neurologic deficits depending on the site of hematoma and brain injury, increased intracranial pressure leading to herniation of brain and ischemia due to reduced blood supply and seizures.
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]
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]
Second-impact syndrome (SIS) occurs when the brain swells rapidly, and catastrophically, after a person has a second concussion before symptoms from an earlier one have subsided. This second blow may occur minutes, days, or weeks after an initial concussion, [ 1 ] and even the mildest grade of concussion can lead to second impact syndrome. [ 2 ]
Instead, it is most commonly associated with hemorrhage of small vessels in the cerebral cortex. [2] The strongest risk factor for intraparenchymal hemorrhage associated with cerebral amyloid angiopathy is old age, and cerebral amyloid angiopathy is most frequently seen in patients who already have, or will soon be diagnosed with, dementia. [3]
Types of brain herniation The most common presentation of cerebrovascular diseases is an acute stroke, which occurs when blood supply to the brain is compromised. [ 13 ] Symptoms of stroke are usually rapid in onset, and may include weakness of one side of the face or body, numbness on one side of the face or body, inability to produce or ...
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]