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Topic: Brain herniation

	Brain herniation - Wikipedia, the free encyclopedia
		The brain can shift by such structures as the falx cerebri, the tentorium, and even through the hole called the foramen magnum in the base of the skull (through which the spinal cord connects with the brain).
		Herniation can be caused by a number of factors that increase intracranial pressure such as traumatic brain injury.
		In central herniation, the diencephalon and parts of the temporal lobes of both of the cerebral hemispheres are squeezed through a notch in the tentorium (Cornell, 1998; Shepherd, 2004).
	en.wikipedia.org /wiki/Brain_herniation (646 words)

	Brain abscess - Wikipedia, the free encyclopedia
		Brain abscess (or cerebral abscess) is an abscess caused by inflammation and collection of infected material coming from local (ear infection, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone, epidural abscess) or remote (lung, heart, kidney etc.) infectious sources within the brain tissue.
		The symptoms of brain abscess are caused by a combination of increased intracranial pressure due to a space-occupying lesion (headache, vomiting, confusion, coma), infection (fever, fatigue etc.) and focal neurologic brain tissue damage (hemiparesis, aphasia etc.).
		Organisms that are most frequently-associated with brain abscess in patients with AIDS are Toxoplasma gondii and Cryptococcus neoformans, though in infection with the latter organism, symptoms of meningitis generally predominate.
	en.wikipedia.org /wiki/Brain_abscess (469 words)

	Brain Herniation Radiology, Pathology, and Neurology
		Descending transtentorial herniations are a larger category caused by mass effect in the cerebrum which pushes the supratentorial brain through the incisura to the posterior fossa.
		The ipsilateral cistern is widened because of the fact that the brain stem is inferiorly contiguous with the spinal cord leading to a long rigid structure as shown in the coronal CT image.
		Uncal herniation is a subset of descending transtentorial herniations.
	rad.usuhs.mil /rad/herniation (2507 words)

	- Northwestern Memorial Hospital - Chicago
		Brain herniation is the mechanical displacement of brain, cerebrospinal fluid, and blood vessels outside the compartments in the head that they normally occupy.
		Brain herniation itself often causes massive stroke, resulting from poor blood supply to some areas of brain and compression of vital structures that compromise cardiovascular and respiratory centers.
		Brain herniations are the most common secondary effect of expanding intracranial masses.
	www.nmh.org /nmh/adam/adamencyclopedia/HIEArticles/001421.htm (542 words)

	skull_cont
		Brain herniation refers to displacement of a portion of the brain from its normal position through openings in the inelastic dura secondary to focal or diffuse intracranial pressure.
		Lateral herniation of the cingulate gyrus beneath the falx is called subfalcine or cingulate herniation and is characterized on axial CT by herniation of the corpus callosum and the ipsilateral lateral ventricle beneath the falx.
		The early findings of brain infarction on non-contrast head CT include hyperdensity in the region of the middle or anterior cerebral artery reflective of acute thrombus; hypodensity of the basilar ganglia, loss of insular cortex, and hypodensity of the white matter; and slight mass effect.
	www.uth.tmc.edu /radiology/test/er_primer/skull_brain/skull.html (3300 words)

	Welcome to DailySentinel!
		This is commonly the result of brain swelling (cerebral edema) from a head injury, or may be the result of space-occupying lesions such as primary brain tumor, metastatic brain tumor, or other lesions within the brain.Brain herniation may also occur with bacterial meningitis.
		The most common type of brain herniation occurs when a portion of the temporal lobe is displaced (uncal herniation), which compresses cranial nerve III, the midbrain, and the posterior cerebral artery, leading to coma and respiratory arrest (breathing stops).
		This compresses the brainstem and causes death from lack of breathing (the respiratory center in the brain stem is destroyed) and circulation.
	www.dailysentinel.com /search/healthfd/shared/health/adam/ency/article/001421.html (327 words)

	Brain herniation
		A brain herniation is the displacement of brain tissue, cerebrospinal fluid, and blood vessels outside the compartments in the head that they normally occupy.
		A herniation can occur through a natural opening at the base of the skull (called the foramen occipitalis) or through surgical openings created by a craniotomy procedure.
		Herniation can also occur between compartments inside the skull, such as those separated by a rigid membrane called the "tentorium".
	www.umm.edu /ency/article/001421.htm (271 words)

	Critical Care Nurse: Intracranial hypertension: monitoring and nursing assessment (Site not responding. Last check: 2007-08-11)
		Traumatic brain injury is a major cause of morbidity and mortality; it accounted for 50 000 deaths in 1998.
		Second, sustained ICP elevations can also lead to herniation syndromes, which are due to a shifting of brain tissue from an area of high pressure, such as occurs with a unilateral lesion within one cerebral hemisphere, to an area of lower pressure.
		Central herniation, caused by brain swelling or an expanding space-occupying lesion, causes compression and lengthening of the diencephalon.
	www.findarticles.com /p/articles/mi_m0NUC/is_5_24/ai_n6332739 (1376 words)

	MedlinePlus Medical Encyclopedia: Brain herniation
		Brain herniations are the most common secondary effect of expanding masses in the brain.
		Once herniation in the brain's temporal lobe or the cerebellum occurs, death is often inevitable.
		Herniation of other areas of the brain areas has a more variable outlook.
	www.nlm.nih.gov /medlineplus/ency/article/001421.htm (631 words)

	eMedicine - Brain, Herniation : Article by Margaret Loh-Lee, MD (Site not responding. Last check: 2007-08-11)
		Herniations of the brain are divided in 5 major categories: (1) transtentorial, (2) subfalcine/cingulate, (3) foramen magnum/tonsillar, (4) sphenoid/alar, and (5) extracranial.
		With subfalcine/cingulate herniation, the supratentorial brain is displaced underneath the anterior falx.
		In cases of descending transtentorial herniation of the brain caused by a large subdural hematoma, emergency surgical decompression is required to prevent irreversible and catastrophic injury to the brainstem, as well as other areas of the brain.
	www.emedicine.com /radio/topic98.htm (2484 words)

	eMedicine - Head Trauma : Article by Scott Shepard, MD
		The brain does not move with the skull, and the skull impacts the brain, causing translation and deformation of the brain.
		Subfalcine herniation occurs when the cingulate gyrus on the medial aspect of the frontal lobe is displaced across the midline under the free edge of the falx.
		In this form of herniation, the cerebellar tonsils are displaced in a downward direction through the foramen magnum, causing compression on the lower brainstem and upper cervical spinal cord as they pass through the foramen magnum.
	www.emedicine.com /med/topic2820.htm (11393 words)

	Introduction: Head Injuries: Merck Manual Home Edition
		The result may be a herniation, in which brain tissue is forced through a small natural opening in the relatively rigid sheets of tissue that separate the brain into right and left compartments and into upper and lower compartments.
		Herniation of the brain can be life threatening if pressure is put on the brain stem, the lower part of the brain, which controls such vital functions as heart rate and breathing.
		Basic brain function is evaluated by checking the size of the pupils and their reaction to light, by evaluating the response to sensations such as heat or pinpricks, and by testing the ability to move the arms and legs.
	www.merck.com /mmhe/sec06/ch087/ch087a.html (2307 words)

	Brain Tumors - WSAVA 2002
		Primary brain tumors originate from cells normally found within the brain and meninges, while secondary tumors are metastasis from a primary tumor located outside the nervous system, or by local invasion from adjacent non- neural tissues (e.g., bone).
		Brain tumors cause cerebral dysfunction through infiltration of normal brain tissue, compression of adjacent structures, disruption of cerebral circulation and local necrosis.
		The aims of therapy for a brain tumor are to eliminate the tumor or reduce its size and to control secondary effects (e.g., increased ICP or cerebral edema).
	www.vin.com /proceedings/Proceedings.plx?CID=WSAVA2002&PID=pr02631 (1980 words)

	TRAUMA.ORG : Neurotrauma : Acute Management (Site not responding. Last check: 2007-08-11)
		Assessment of brain injury hinges on evaluation of the Glasgow Coma Score (GCS) and examination of the pupils.
		However brain injury management should be instituted on the basis of the initial examination and there should be no delay to assess whether the GCS improves with volume resuscitation.
		This is identified by unilateral abnormal posturing and/or the presence of a unilateral dilated pupil.
	www.trauma.org /neuro/acutemanagement.html (853 words)

	Radiology In Ped Emerg Med, Vol 5, Case 6
		In transtentorial herniation the medial portions of the temporal lobes (uncus) and the brainstem herniate downward from supratentorial to the infratentorial compartment.
		As herniation worsens, decerebrate (extensor) posturing, contralateral (ie., bilateral) pupillary dilation and Cushing's triad occur.
		Tonsillar herniation: In tonsillar herniation (rare), a mass effect in the posterior fossa causes the cerebellar tonsils to herniate inferiorly through the foramen magnum compressing the medulla and upper cervical spinal cord.
	www.hawaii.edu /medicine/pediatrics/pemxray/v5c06.html (1984 words)

	Radiology In Ped Emerg Med, Vol 5, Case 7
		Early brain edema on CT can be identified with a decrease in the size of the third ventricle and the basal cisterns.
		The different brain herniation syndromes are described in Case 6 of this volume.
		With cerebral edema, the brain is hypodense and the normal falx may appear to have increased density.
	www.hawaii.edu /medicine/pediatrics/pemxray/v5c07.html (2819 words)

	NPEL:Basic Reactions
		The total water content of the brain may or may not be increased depending on the nature of the edema.
		Keeping in mind that the brain is housed in a rigid, non-expansible container, it is only capable of a limited increase in its volume before it begins to bump up against the inside of the skull.
		In such situations, the brain may swell due to severe cerebral edema such that the intracranial pressure eventually exceeds mean arterial pressure.
	www.uvm.edu /~jkessler/NP/neuropbr.htm (1461 words)

	AANS.org \| Education and Meetings \| AANS Scientific Journals \| Neurosurgical Focus
		Uncal herniation was noted if a patient developed pupillary irregularity and/or enlargement ipsilateral to the stroke in association with a decline in consciousness and development of extremity posturing.
		Clinical herniation developed in six (46%) of 13 patients with a mean CBF of 15 ml/100 g/minute or lower in the symptomatic MCA territory, whereas no clinical herniation developed in the seven patients with a mean CBF higher than 15 ml/100 g/minute in the same location.
		All six patients (100%) in whom life-threatening herniation developed had a mean CBF of 15 ml/100 g/minute or lower in the symptomatic MCA territory and the development of life-threatening uncal herniation was significantly associated with this level of CBF in the symptomatic MCA territory (p < 0.05; Fisher's exact test).
	www.aans.org /education/journal/neurosurgical/june98/4-6-p1.asp (4135 words)

	Welcome to AJC! \| ajc.com
		If obstructive hydrocephalus is present, placing an external ventricular drain may prevent brain herniation.Reducing or removing tumors by surgery may reduce intracranial pressure and prevent brain herniation.
		Corticosteroids such as dexamethasone can reduce brain swelling (cerebral edema) and intracranial pressure, especially in cases where tumor edema is involved; they may prevent imminent brain herniation.
		Once herniation of the temporal lobe or the cerebellum occurs, death is often inevitable.Herniation of other brain areas has a variable prognosis (probable outcome).
	www.ajc.com /living/healthfd/shared/health/adam/ency/article/001421trt.html (293 words)

	Forebrain disease in older cats: Look for intracranial neoplasia - DVM
		Brain neoplasia One of the most-common causes of progressive forebrain dysfunction in cats is intracranial neoplasia with meningiomas occurring far more frequently than any other tumor.
		The primary effects are compression and infiltration of adjacent brain tissue by the tumor.
		However, cats with either caudal transtentorial or foramen magnum brain herniation often deteriorate rapidly due to compression of the brain stem by the herniated tissue.
	www.dvmnewsmagazine.com /dvm/article/articleDetail.jsp?id=122100 (682 words)

	Brain Herniation (Tentorial Herniation)
		A brain herniation occurs when a part of the brain pushes downward inside the skull through the opening that leads into the neck.
		Conditions that cause swelling in the brain or increased pressure in the skull can cause brain tissue to be pushed into this opening.
		Examples of bleeding in the brain are epidural hematoma, subdural hematoma, or subarachnoid hemorrhage.
	www.3-rx.com /brain-herniation/default.php (273 words)

	risks complications lumbar puncture
		One of the functions of CSF surrounding the brain is to cushion the brain from injury against the skull.
		The pressure of the brain on the pain fibers in the dura is thought to be the pathophysiologic basis of headache following lumbar puncture with removal of CSF.
		The size of the hole left by the spinal needle depends on the size (guage) of the needle: usually the smallest possible needle is used to avoid the complication of "spinal headache" but sometimes even a small hole is enough to allow a large amount of CSF to leak.
	uscneurosurgery.com /infonet/surgery/understand/risks/procedure/LP.htm (801 words)

	Central Brain Herniation Secondary to JuvenileDiabetic Ketoacidosis -- Shrier et al. 20 (10): 1885 -- American Journal ...
		in central brain herniation is an uncommon complication of the
		Central or transtentorial herniation of the diencephalon is
		transtentorial herniation or as a complication of bilateral
	www.ajnr.org /cgi/content/full/20/10/1885 (1685 words)

	NPEL:Basic Reactions, Part II (Site not responding. Last check: 2007-08-11)
		Since the brain is housed in a rigid, non-expansible container, it is only capable of a limited increase in its volume before it begins to bump up against the inside of the skull.
		Subfalcian herniation: Herniation of the cingulate gyrus under the falx cerebri.
		Tonsillar herniation: Herniation of the cerebellar tonsils through the foramen magnum (usually a terminal event).
	cats.med.uvm.edu /cats_teachingmod/pathology/path302/np/neuro_basic/neuropbr2.htm (1049 words)

	CJNS - Brain Herniation: A Revision of Classical Concepts - Review Article
		Combining clinical, pathologic, computed tomography and magnetic resonance imaging data, it is concluded that temporal lobe herniation is not the means by which the midbrain sustains irreversible damage in acute cases, but rather lateral displacement of the brain at the tentorium is the prime mover and herniation a harmless accompaniment.
		Transtentorial herniation has been investigated with computed tomography using the three calcification relationship and descent through the tentorial opening could not be documented.
		Bilateral brain stem compression in acute bilateral cases must be distinguished from herniation.
	www.cjns.org /22maytoc/brain.htm (179 words)

	BRAIN HERNIATION
		The increased intracranial pressure forces the brain downward inside the skull.
		May occur secondary to head injury, primary or metastatic brain tumor, bacterial meningitis, and brain abscess.
		Brain herniations may involve different portions of the brain such as the cerebellum (cerebellar herniation), uncus (uncal herniation), and transtentorial herniation of the cerebrum.
	www.medhelp.org /glossary/new/GLS_0797.HTM (110 words)

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