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Brain herniation - Treatment

Alternative Names

Herniation syndrome; Transtentorial herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain

Treatment:

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:

  • Placing a drain placed into the brain to help remove fluid
  • Corticosteroids such as dexamethasone, especially if there is a brain tumor
  • Medications that remove fluid from the body such as mannitol or other diuretics, which reduce pressure inside the skull
  • Placing a tube in the airway (endotracheal intubation) and increasing the breathing rate to reduce the levels of carbon dioxide (CO2) in the blood
  • Removing the blood if bleeding is causing herniation

Expectations (prognosis):

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.

Complications:

  • Brain death
  • Permanent and significant neurologic problems

Calling your health care provider:

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.

  • Reviewed last on: 9/22/2008
  • 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.

References

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.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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