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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]
Other possibilities resulting from brain stem distortion include lethargy, slow heart rate, and pupil dilation. [9] Uncal herniation may advance to central herniation. [7] The sliding uncus syndrome represents uncal herniation without alteration in the level of consciousness and other sequelae mentioned above.
This may succeed or accompany temporal lobe (uncal) herniation and subfalcian herniation secondary to a supratentorial mass. [ citation needed ] The pathophysiological mechanism is uncertain [ 7 ] but is probably caused by the displacement of the brainstem stretching and tearing perforating branches of the basilar artery to the pons; venous ...
Cushing reflex (also referred to as the vasopressor response, the Cushing effect, the Cushing reaction, the Cushing phenomenon, the Cushing response, or Cushing's Law) is a physiological nervous system response to increased intracranial pressure (ICP) that results in Cushing's triad of increased blood pressure, irregular breathing, and bradycardia. [1]
Abnormal posturing is an involuntary flexion or extension of the arms and legs, indicating severe brain injury.It occurs when one set of muscles becomes incapacitated while the opposing set is not, and an external stimulus such as pain causes the working set of muscles to contract. [1]
In adults, the temporal region accounts for 75% of cases. In children, however, they occur with similar frequency in the occipital, frontal, and posterior fossa regions. [3] Epidural bleeds from arteries can grow until they reach their peak size 6–8 hours post-injury, spilling 25–75 cubic centimeters of blood into the intracranial space. [8]
Intracranial hypertension (IH), also called increased ICP (IICP) or raised intracranial pressure (RICP), refers to elevated pressure in the cranium. 20–25 mmHg is the upper limit of normal at which treatment is necessary, though it is common to use 15 mmHg as the threshold for beginning treatment.
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.