What is Brain Herniation?
Brain Herniation is an emergent pathological condition of the brain which occurs when a part of the brain tissue is forcefully pushed from one side of the brain to the other which tends to result in increased pressure within the skull. This increased pressure within the skull may be life threatening and needs prompt treatment.
Anatomically speaking, the brain is supported within the skull by an extremely tough tissue called tentorium. This tissue has an opening in it which connects the brainstem to the brain. This opening is exactly the location where majority of Brain Herniations occur. Conditions like brain abscess or brain tumor which cause swelling of the brain and increase pressure in the brain can cause the brain tissue to be pushed towards this opening and cause Brain Herniation. In cases of a tumor, the swelling in the brain will force the brain to move and thus there will be a shifting of the brain from its usual position causing Brain Herniation.
What Causes Brain Herniation and What are the Risk Factors?
The main cause of Brain Herniation is anything which increases pressure within the brain causing the brain to move from its position. Head injury, brain tumor, brain abscess, or strokes are the main causes that result in swelling and increased pressure in the brain causing Brain Herniation. A Brain Herniation can occur due to the following:
- Brain Hemorrhage
- Hydrocephalus
- Swelling after radiation therapy for a brain tumor.
What are the Symptoms of Brain Herniation?
Some of the symptoms of Brain Herniation are
- Coma
- Headache
- Lethargy
- Loss of all brainstem reflexes
- Loss of consciousness
- Respiratory arrest
- Dilated pupils.
How is Brain Herniation Diagnosed?
- Individuals with Brain Herniation tend to have
- Persistent high blood pressure
- Irregular breathing patterns
- Irregular and generally slow pulse
Apart from the above findings, if a neurological examination shows altered awareness and changes in reflexes and other nerve related functions a diagnosis of Brain Herniation is made. It should be noted that the location where the Brain Herniation occurs and the actions that the area controls in the body will be severely affected. Advanced imaging studies like CT and MRI scan of the brain will clearly show a change in the anatomical position of the brain and pinpoint the diagnosis of Brain Herniation.
How is Brain Herniation Treated?
As stated, Brain Herniation is an emergent medical condition and needs to be treated immediately. The main aim of treatment is to decrease the swelling and try and reverse the herniation. This may be done by the following:
- Placing a drain into the brain to help remove cerebrospinal fluid
- Utilizing corticosteroids to try and reduce swelling
- Diuretics which remove fluid from the body so as to reduce pressure from the brain
- Endotracheal intubation to increase the rate of breathing and reduce the carbon di oxide levels in the blood
- Removing blood clots in case if they are increasing the pressure in the brain
- Removing a section of the skull to give the brain more space.
What is the Prognosis of Brain Herniation?
Unfortunately, the prognosis of an individual with Brain Herniation is quite poor as the cause of the condition in itself decreases the life span of the patient such as a brain abscess or a brain tumor, which further decreases as a result of the swelling and increased pressure in the brain caused by Brain Herniation.
