Learning objectives
To describe the types of hernia and associated neurologic symptoms.
Background
Cerebral herniation is the displacement of cerebral matter from its normal location to an adjacent site, secondary to an abnormal increase of the intracranial volume. Several conditions such as tumor growth, haedema, haemorrage can predispose to raise intracranial pressure and consequently determine increase of intracranial volume.
Brain herniation may cause brain pressure necrosis, compress cranial nerves and vessels causing hemorrhage or ischemia, and obstruct the normal circulation of CSF, producing hydrocephalus.
Therefore, each type of hernia may be associated with a specific neurologic syndrome. Consequently,...
Findings and procedure details
CT and MR are imaging technique of choice for identifying the brain structures and direction and entity of displacement, and are also pivotal for detecting indirect signs of herniation, such as obliteration of liquor spaces and loss of normal anatomical relationships of the involved structures.
Brain herniation can be classified into two broad categories: intracranial and extracranial.
The cranial cavity is compartmented by bony structures and by dural reflections; the major of them are the falx cerebri and the cerebellar tentorium, which define two supratentorial...
Conclusion
Cerebral herniation syndromes represent a common life-threatening condition and misdiagnosis can lead to increased patient morbidity and even death.
CT and MR are necessary for establishing the diagnosis, guiding the therapeutic decisions and determining the prognosis.
Personal information and conflict of interest
M. A. Maresca; Parma/IT - nothing to disclose N. Sverzellati; Parma/IT - nothing to disclose M. Pedrazzini; Fidenza (Parma)/IT - nothing to disclose
References
1)1-Gilardi et al. Types of Cerebral Herniation and Their Imaging Features. RadioGraphics 2019; 39:1598–1610.
2)2-Osborn AG, Gary L. Hedlund, DO Salzman KL, Osborn's Brain: Imaging, Pathology, and Anatomy (2° edition) Salt Lake City, UT : Elsevier, Inc., 2017.
3)3-Munakomi S, M Das J. Brain Herniation. [Updated 2019 Dec 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK542246/