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Brain herniation

Contents of this page:


Brain hernia
Brain hernia

Alternative Names    Return to top

Herniation 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 top

Nkwuo 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.

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