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Intracranial Herniation Syndromes
Surjith Vattoth, MD, FRCR; Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Subfalcine herniation (SFH)
                • Descending transtentorial herniation (DTH)
              • Definitions

                • Herniation of brain from one compartment (normally separated by calvarial &/or dural boundaries) to another

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Park HY et al: Sinking skin flap syndrome or syndrome of the trephined: a report of two cases. Ann Rehabil Med. 43(1):111-4, 2019
                                      2. Saran S et al: Neglected type III growing skull fracture in a 65-year-old female. Ann Afr Med. 17(1):46-7, 2018
                                      3. Ji H et al: Paradoxical herniation after unilateral decompressive craniectomy: a retrospective analysis of clinical characteristics and effectiveness of therapeutic measures. Turk Neurosurg. 27(2):192-200, 2017
                                      4. Wu H et al: The diagnosis and surgical treatment of central brain herniations caused by traumatic bifrontal contusions. J Craniofac Surg. 25(6):2105-8, 2014
                                      5. Arbour RB: Early metabolic/cellular-level resuscitation following terminal brain stem herniation: implications for organ transplantation. AACN Adv Crit Care. 24(1):59-78, 2013
                                      6. Bor-Seng-Shu E et al: Posttraumatic refractory intracranial hypertension and brain herniation syndrome: cerebral hemodynamic assessment before decompressive craniectomy. Biomed Res Int. 2013:750809, 2013
                                      7. Young GB: Impaired consciousness and herniation syndromes. Neurol Clin. 29(4):765-72, 2011
                                      8. Kalita J et al: Brain herniations in patients with intracerebral hemorrhage. Acta Neurol Scand. 119(4):254-60, 2009
                                      9. Hussain SI et al: Brainstem ischemia in acute herniation syndrome. J Neurol Sci. 268(1-2):190-2, 2008
                                      10. Marupaka SK et al: Atypical Duret haemorrhages seen on computed tomography. Emerg Med Australas. 20(2):180-2, 2008
                                      11. Timms C et al: Brainstem distortion from postoperative cerebellar herniation through a dural and bony defect. J Clin Neurosci. 15(9):1050-1, 2008
                                      12. Yoo WK et al: Kernohan's notch phenomenon demonstrated by diffusion tensor imaging and transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry. 79(11):1295-7, 2008
                                      13. Laine FJ et al: Acquired intracranial herniations: MR imaging findings. AJR Am J Roentgenol. 165:967-73, 1995
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Subfalcine herniation (SFH)
                                                    • Descending transtentorial herniation (DTH)
                                                  • Definitions

                                                    • Herniation of brain from one compartment (normally separated by calvarial &/or dural boundaries) to another

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Park HY et al: Sinking skin flap syndrome or syndrome of the trephined: a report of two cases. Ann Rehabil Med. 43(1):111-4, 2019
                                                                          2. Saran S et al: Neglected type III growing skull fracture in a 65-year-old female. Ann Afr Med. 17(1):46-7, 2018
                                                                          3. Ji H et al: Paradoxical herniation after unilateral decompressive craniectomy: a retrospective analysis of clinical characteristics and effectiveness of therapeutic measures. Turk Neurosurg. 27(2):192-200, 2017
                                                                          4. Wu H et al: The diagnosis and surgical treatment of central brain herniations caused by traumatic bifrontal contusions. J Craniofac Surg. 25(6):2105-8, 2014
                                                                          5. Arbour RB: Early metabolic/cellular-level resuscitation following terminal brain stem herniation: implications for organ transplantation. AACN Adv Crit Care. 24(1):59-78, 2013
                                                                          6. Bor-Seng-Shu E et al: Posttraumatic refractory intracranial hypertension and brain herniation syndrome: cerebral hemodynamic assessment before decompressive craniectomy. Biomed Res Int. 2013:750809, 2013
                                                                          7. Young GB: Impaired consciousness and herniation syndromes. Neurol Clin. 29(4):765-72, 2011
                                                                          8. Kalita J et al: Brain herniations in patients with intracerebral hemorrhage. Acta Neurol Scand. 119(4):254-60, 2009
                                                                          9. Hussain SI et al: Brainstem ischemia in acute herniation syndrome. J Neurol Sci. 268(1-2):190-2, 2008
                                                                          10. Marupaka SK et al: Atypical Duret haemorrhages seen on computed tomography. Emerg Med Australas. 20(2):180-2, 2008
                                                                          11. Timms C et al: Brainstem distortion from postoperative cerebellar herniation through a dural and bony defect. J Clin Neurosci. 15(9):1050-1, 2008
                                                                          12. Yoo WK et al: Kernohan's notch phenomenon demonstrated by diffusion tensor imaging and transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry. 79(11):1295-7, 2008
                                                                          13. Laine FJ et al: Acquired intracranial herniations: MR imaging findings. AJR Am J Roentgenol. 165:967-73, 1995