Brain herniation

Alternative names:

cerebellar herniation; herniation of the brain; herniation syndrome; transtentorial herniation; uncal herniation

Treatment:

Brain herniation is a medical emergency! The goal of treatment is preservation of life.

Preventing and treating increased intracranial pressure prevents brain herniation. If obstructive hydrocephalus is present, placing a surgical shunt may prevent brain herniation. Reducing or removing tumors by surgery may reduce intracranial pressure and prevent brain herniation.

Corticosteroids such as dexamethasone reduce brain swelling (cerebral edema) and intracranial pressure, and may prevent imminent brain herniation. Mannitol or other osmotic diuretics may be given to reduce intracranial pressure.

Deliberate hyperventilation may also be used to reduce intracranial pressure. This often includes placement of a tube in the airway (endotracheal intubation) and mechanically ventilating (forced breathing) at a rapid rate.

Expectations (prognosis):

Once herniation of the temporal lobe or the cerebellum occurs, death is usually inevitable. Herniation of other brain areas has a variable prognosis (probable outcome).

Complications:

• permanent and profound neurologic losses
• death

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if decreased alertness or other symptoms develop suddenly, particularly if there is a known head injury or brain lesion.