What happens in uncal herniation?
Uncal herniation occurs when rising intracranial pressure causes portions of the brain to move from one intracranial compartment to another. It is a life-threatening neurological emergency and indicates the failure of all adaptive mechanisms for intracranial compliance.
What happens when brain Herniates?
Loss of consciousness, coma. Loss of all brainstem reflexes (blinking, gagging, and pupils reacting to light) Respiratory arrest (no breathing) Wide (dilated) pupils and no movement in one or both eyes.
Where is the uncal herniation?
Uncal herniation is the most common cerebral herniation syndrome. The uncus is located in the inferior, medial aspect of the temporal lobe. This structure, and the adjacent parahippocampal gyrus, can herniate through the tentorial notch.
What is Transtentorial herniation importance?
A transtentorial herniation is the movement of brain tissue from one intracranial compartment to another. This includes uncal, central, and upward herniation. These are life-threatening and time-critical pathologies that may be reversible with emergent surgical intervention and medical management.
What is the importance of Transtentorial herniation?
What herniation means?
: to protrude through an abnormal body opening : rupture a herniated intervertebral disk.
What does the brain stem control?
The brainstem is the stalklike part of your brain that connects your brain to your spinal cord (column of nerve tissue that runs down your spine). Your brainstem helps regulate some body functions, including your breathing and heart rate. The brainstem also controls your balance, coordination and reflexes.
What is Transtentorial and uncal herniation?
Uncal herniation is a subtype of transtentorial downward brain herniation that involves the uncus, usually related to cerebral mass effect increasing the intracranial pressure.
What does uncal herniation mean in medical terms?
Uncal herniation occurs when rising intracranial pressure causes portions of the brain to flow from one intracranial compartment to another; this is a life-threatening neurological emergency and indicates the failure of all adaptive mechanisms for intracranial compliance.
Where does the uncus herniate in the brain?
The uncus herniates over the tentorial notch and pushes against the brainstem and corresponding cranial nerves, compressing the third cranial nerve located just medial to the uncus. History and Physical A patient with impending uncal herniation will initially present with symptoms of increased intracranial pressure.
What is the next step for the management of uncal herniation?
The next step for the management of uncal herniation if clinical signs do not resolve with interventions to reduce intracranial pressure is to consider decompressive surgical options.[1] These include: Placement of a ventricular drain
Can a uncal herniation cause third nerve palsy?
The anatomy varies among patients, and in some cases, there is no uncal herniation or it is the contralateral pupil that dilates first, so that the mechanism of the third nerve palsy is likely to be central (i.e., intrinsic to the midbrain) in these cases.