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Alternative Names Return to topHerniation syndrome; Transtentorial herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain
Definition Return to top
A brain herniation is when brain tissue, cerebrospinal fluid, and blood vessels are moved or pressed away from their usual position in the head.
Causes Return to top
A brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most often the result of brain swelling from a head injury.
Brain herniations are the most common side effect of tumors in the brain, including:
A brain herniation can also be caused by:
A brain herniation can occur:
Symptoms Return to top
Exams and Tests Return to top
A neurological exam shows changes in alertness (consciousness). Depending on the severity of the herniation, there will be problems with one or more brain-related reflexes and cranial nerve functions.
Patients with a brain herniation have irregular heart rhythms and difficulty breathing consistently.
Treatment Return to top
Brain herniation is a medical emergency. The goal of treatment is to save the patient's life.
To help reverse or prevent a brain herniation, the medical team will treat increased swelling and pressure in the brain. Treatment may involve:
Outlook (Prognosis) Return to top
The outlook varies and depends on where in the brain the herniation occured. Death is possible.
A brain herniation itself often causes massive stroke. There can be damage to parts of the brain that control breathing and blood flow. This can rapidly lead to death or brain death.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your local emergency number (such as 911) or take the patient to a hospital emergency room if decreased alertness or other symptoms suddenly develop, especially if there has been a head injury or if the person has a brain tumor or blood-vessel malformation.
Prevention Return to top
Prompt treatment of increased intracranial pressure and related disorders may reduce the risk of brain herniation.
References Return to topNkwuo N, Schamban N, Borenstein M. Selected Oncologic Emergencies. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 121. Update Date: 9/22/2008 Updated by: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.