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In transcalvarial herniation, the brain squeezes through a fracture or a surgical site in the skull. [7] Also called "external herniation", this type of herniation may occur during craniectomy, surgery in which a flap of skull is removed, the protruding brain region preventing the piece of skull from being replaced during the operation. [1]
Midline shift is a shift of the brain past its center line. [1] The sign may be evident on neuroimaging such as CT scanning . [ 1 ] The sign is considered ominous because it is commonly associated with a distortion of the brain stem that can cause serious dysfunction evidenced by abnormal posturing and failure of the pupils to constrict in ...
The falx cerebri is a strong, crescent-shaped sheet of dura mater lying in the sagittal plane between the two cerebral hemispheres. [3] It is one of four dural partitions of the brain along with the falx cerebelli, tentorium cerebelli, and diaphragma sellae; it is formed through invagination of the dura mater into the longitudinal fissure between the cerebral hemispheres.
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 hematoma can exert a mass effect on the brain, increasing intracranial pressure and potentially causing midline shift or deadly brain herniation. In the past this effect held additional diagnostic importance since prior to the invention of modern tomographic soft-tissue imaging utilizing MRI or CT it was not possible to directly image many ...
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]
When the epidural hematoma is large enough, it will cause mass effect on contralateral brain which lead to midline, subfalcine (below the falx cerebri), and trans-tentorial (crossing tentorium cerebelli) herniations. This phenomenon can cause the subject to lose consciousness and eventually to death. [3]
Thus, if you have a right hemisphere trans-tentorial herniation, it causes a Kernohan's notch in the left cerebral peduncle which results in right-sided motor impairment. Therefore, you get, paradoxically, impairment of motor function on the same side of the body as the herniation which caused the Kernohan's notch on the contralateral side. [3]