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".
Alternative NamesHerniation syndrome; Transtentorial herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain
A brain herniation occurs when pressure inside the skull (intracranial pressure) increases and displaces brain tissues. This is commonly the result of brain swelling from a head injury. It can also be caused by space-occupying lesions such as primary brain tumor, metastatic brain tumor, and hemorrhages or strokes that produce swelling within the brain. Hydrocephalus (accumulation of fluid in the brain) can also lead to brain herniation.
A brain herniation itself often causes massive stroke. This results from poor blood supply to some areas of the brain and compression of vital structures that regulate your breathing and circulation. This can rapidly lead to death or brain death.
Brain herniations are the most common secondary effect of expanding masses in the brain.
- Progressive loss of consciousness
- Irregular breathing
- Respiratory arrest (no breathing)
- Irregular pulse
- Cardiac arrest (no pulse)
- Loss of all brainstem reflexes (blink, gag, pupillary reaction to light)
Exams and Tests
A neurologic examination would show an impaired level of consciousness. Depending on the severity of the herniation, one or several brainstem reflexes and cranial nerve functions will be impaired. The patient would show an inability to breathe consistently, and heart rhythms would be irregular.
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
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.
- Permanent and significant neurologic problems
- Brain death
When to Contact a Medical Professional
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.
Prompt treatment of increased intracranial pressure and related disorders may reduce the risk of brain herniation.
Typical mistypes for Brain herniation
vrain herniation, nrain herniation, hrain herniation, grain herniation, beain herniation, bdain herniation, bfain herniation, btain herniation, b5ain herniation, b4ain herniation, brzin herniation, brsin herniation, brwin herniation, brqin herniation, braun herniation, brajn herniation, brakn herniation, braon herniation, bra9n herniation, bra8n herniation, braib herniation, braim herniation, braij herniation, braih herniation, brain gerniation, brain berniation, brain nerniation, brain jerniation, brain uerniation, brain yerniation, brain hwrniation, brain hsrniation, brain hdrniation, brain hrrniation, brain h4rniation, brain h3rniation, brain heeniation, brain hedniation, brain hefniation, brain hetniation, brain he5niation, brain he4niation, brain herbiation, brain hermiation, brain herjiation, brain herhiation, brain hernuation, brain hernjation, brain hernkation, brain hernoation, brain hern9ation, brain hern8ation, brain herniztion, brain hernistion, brain herniwtion, brain herniqtion, brain herniarion, brain herniafion, brain herniagion, brain herniayion, brain hernia6ion, brain hernia5ion, brain herniatuon, brain herniatjon, brain herniatkon, brain herniatoon, brain herniat9on, brain herniat8on, brain herniatiin, brain herniatikn, brain herniatiln, brain herniatipn, brain herniati0n, brain herniati9n, brain herniatiob, brain herniatiom, brain herniatioj, brain herniatioh, rain herniation, bain herniation, brin herniation, bran herniation, brai herniation, brainherniation, brain erniation, brain hrniation, brain heniation, brain heriation, brain hernation, brain hernition, brain herniaion, brain herniaton, brain herniatin, brain herniatio, rbain herniation, barin herniation, brian herniation, brani herniation, brai nherniation, brainh erniation, brain ehrniation, brain hreniation, brain henriation, brain herination, brain hernaition, brain hernitaion, brain herniaiton, brain herniatoin, brain herniatino, bbrain herniation, brrain herniation, braain herniation, braiin herniation, brainn herniation, brain herniation, brain hherniation, brain heerniation, brain herrniation, brain hernniation, brain herniiation, brain herniaation, brain herniattion, brain herniatiion, brain herniatioon, brain herniationn, etc.