Brain herniation

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Brain

Brain hernia

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

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

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: 07/14/2006
Reviewed By: J.A. Lee, M.D., Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.