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Brain herniation

• Overview
• Symptoms
• Treatment
• Prevention

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. This can be accomplished by:

• Corticosteroids such as dexamethasone, especially in cases where a tumor is involved
• Mannitol or other diuretics
• A drain placed into the brain to drain off fluid, in the case of a mechanical obstruction causing herniation
• Removing the blood if a massive hemorrhage is present and causing herniation, although the outlook in these cases is poor
• Placing a tube in the airway ( endotracheal intubation ) and mechanically ventilating (forced breathing) at a rapid rate to reduce the levels of carbon dioxide (CO2) in the blood

Expectations (prognosis):

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.

Complications:

• Permanent and significant neurologic problems
• Brain death

Calling your health care provider:

If decreased alertness or other symptoms develop suddenly, particularly if there is a known head injury or brain lesion, go to the emergency room or call 911. A neurologist or neurosurgeon will ultimately be involved in the patient's care.

• Review Date: 7/14/2006
• Reviewed By: J.A. Lee, M.D., Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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