Which brain herniation is the most life threatening?

Central herniation Downward herniation can stretch branches of the basilar artery (pontine arteries), causing them to tear and bleed, known as a Duret hemorrhage. The result is usually fatal.

How many types of brain herniation are there?

Furthermore, intracranial hernias can be subdivided into three basic types: (a) subfalcine hernia; (b) transtentorial hernia, which can be ascending or descending (lateral and central); and (c) tonsillar hernia (Table, Fig 1) (4,5).

Why does brain herniation lead to death?

The outlook varies, depending on where in the brain the herniation occurs. Without treatment, death is likely. There can be damage to parts of the brain that control breathing and blood flow. This can rapidly lead to death or brain death.

What are the signs of brain herniation?

Signs and symptoms may include:

• High blood pressure.
• Irregular or slow pulse.
• Severe headache.
• Weakness.
• Cardiac arrest (no pulse)
• Loss of consciousness, coma.
• Loss of all brainstem reflexes (blinking, gagging, and pupils reacting to light)
• Respiratory arrest (no breathing)

Can brain herniation reversed?

Brain herniation is potentially reversible with appropriate and timely therapy. Reversal of transtentorial herniation has been observed in 50–75 \% of adult patients with either TBI [58] or with supratentorial mass lesions [59].

What is the most common type of brain herniation?

Subfalcine hernia, also known as midline shift or cingulate hernia, is the most common type of cerebral hernia. It is generally caused by unilateral frontal, parietal, or temporal lobe disease that creates a mass effect with medial direction, pushing the ipsilateral cingulate gyrus down and under the falx cerebri.

What are the types of herniation?

Brain herniation is classified as follows:

• Subfalcine herniation.
• Transalar (transsphenoidal) herniation.
• Transtentorial uncal herniation.
• Central (trans-tentorial) herniation (descending and ascending)
• Cerebellar tonsillar herniation.
• Transcalvarial herniation.

Can a person live with brain stem damage?

What happens when you damage your brain stem. When an accident causes brain stem damage, the affects can be devastating. In fact, destruction of the midbrain, pons, or medulla oblongata causes “brain death”, and the unfortunate victim of the injury cannot survive.

How long can someone live with only brain stem activity?

After 5 years, about 3\% of people recover the ability to communicate and understand, but few can live independently, and none can function normally. Most people who remain in a vegetative state die within 6 months of the original brain damage. Most of the others live about 2 to 5 years.

Can you survive a brain stem injury?

When an accident causes brain stem damage, the affects can be devastating. In fact, destruction of the midbrain, pons, or medulla oblongata causes “brain death”, and the unfortunate victim of the injury cannot survive.

When does Transtentorial herniation occur?

Upward transtentorial herniation can occur when an infratentorial mass (eg, tumor in the posterior fossa, cerebellar hemorrhage) compresses the brain stem, kinking it and causing patchy brain stem ischemia. The posterior 3rd ventricle becomes compressed.

What is Cushings reflex?

The Cushing reflex (vasopressor response, Cushing reaction, Cushing effect, and Cushing phenomenon) is a physiological nervous system response to acute elevations of intracranial pressure (ICP), resulting in Cushing’s triad of widened pulse pressure (increasing systolic, decreasing diastolic), bradycardia, and …

What are the different types of brain herniation syndromes?

The four main types of brain herniation syndromes include an uncinate and central transtentorial herniations, as well as a subfalcine or tonsillar herniations. An uncinate or uncal transtentorial herniation (1) occurs when the inner part (medial aspect) of the temporal lobe is pushed against the free margin of the tentorium.

What is brain herniation and how dangerous is it?

Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull.

What is the pathophysiology of a brain hernia?

Overview. A brain herniation, or cerebral herniation, occurs when brain tissue, blood, and cerebrospinal fluid (CSF) shifts from their normal position inside the skull. The condition is usually caused by swelling from a head injury, stroke, bleeding, or brain tumor. A brain herniation is a medical emergency and requires immediate medical…

What is the outlook for someone with a brain herniation?

The outlook depends on the type and severity of the injury that caused the herniation and where in the brain the herniation occurs. A brain herniation can cut off the blood supply to the brain. For this reason, it will likely be fatal if not treated promptly.