Identify the type of Brain herniation by looking in this image
Ans;B. Tonsillar Herniation.
Image shows:Herniation of the cerebellar tonsils (red arrow) and compression of the medulla. The dotted white line shows the level of the foramen magnum.
- It can be caused by a number of factors that cause a mass effect and increase intracranial pressure (ICP): these include traumatic brain injury, intracranial hemorrhage, or brain tumor.
- There are two major classes of herniation: supratentorial and infratentorial.
- Supratentorial herniation
- Ipsilateral Pupil Dilatation(earliest Sgn)
- External Ophthalmoplegia
- Contralateral Hemiparesis
- Decrebrate Posturing
- Variable impairment in consciousness
- Medium Sized Fixed pupils
- Early coma
- Decorticate Posturing
- Cheyne -Stoke Breathing
- Diabetes Insipidus
- Small reactive pupils
- Contralateral Leg Paralysis
- Tectal (posterior)
- Upward (upward cerebellar or upward transtentorial)
- Tonsillar (downward cerebellar)
- Respiratory Arrest
- Bilateral Arm Dysesthesia.
- Brain herniation frequently presents with abnormal posturing a characteristic positioning of the limbs .
- These patients have a lowered level of consciousness, with Glasgow Coma Scores of three to five.
- One or both pupils may be dilated and fail to constrict in response to light.
Vomiting can also occur due to compression of the vomiting center in the medulla oblongata