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Cerebral Herniation

Overview of Cerebral Herniation

Cerebral herniation, also known as brain herniation, occurs when brain tissue, blood, and cerebrospinal fluid (CSF) shift from their normal position inside the skull. 

This is a life-threatening condition and requires immediate medical assistance. Swelling as a result of head injury, stroke, bleeding, or brain tumor is some of the causes of cerebral herniation.

Signs and Symptoms of Cerebral Herniation

Signs and symptoms of brain herniation include: 

Types of Cerebral Herniation

The position where brain tissue has displaced determines the type of cerebral herniation. It can be classified into three categories: 

1. Subfalcine

This is the most common type of brain herniation. Under normal circumstances, the brain tissue moves under a membrane called the falx cerebri in the middle of the brain. In this condition, the tissue ends up pushed to one side. 

2. Transtentorial Herniation 

This can be further divided into: 

  • Descending Transtentorial or Uncal - this is the second most common type of cerebral herniation. The uncus is basically a part of the temporal lobe that is shifted downward into an area called the posterior fossa. 

  • Ascending Transtentorial Herniation - in this type, the cerebellum and the brainstem move a little upward in a membrane known as the tentorium cerebelli. 

3. Cerebellar Tonsillar

There is a natural opening at the base of our skull. This is where the spinal cord connects to the brain. In this type, the cerebral tonsils move downward towards this opening. 


Causes of Cerebral Herniation

It commonly occurs due to swelling. The swelling puts pressure on the brain which causes the to move away from their normal position.  

The common causes of brain herniation are: 

Some other possible reasons can be: 

  • Presence of abscess 
  • Fluid buildup in the brain 
  • Brain surgery 
  • A defect in the brain can also cause this 

Risk Factors of Cerebral Herniation

Brain herniation is a serious condition and its complications can include: 

  • Brain death 
  • Heart attack 
  • Permanent brain damage 
  • Coma 
  • Death





Your doctor will also ask you to undergo some blood and imaging tests for the diagnosis of cerebral herniation.

These may include: 

  • X-ray of skull and neck 
  • CT scan 
  • MRI scan 
  • Blood tests  

In case you exhibit any concerning signs and symptoms of cerebral herniation, consult a neurologist or neurosurgeon as soon as possible.

Treatment of Cerebral Herniation | When to Consult a Doctor

The main goal of brain herniation is to relieve the swelling and pressure in the brain.

Some treatment options can be:

  • A surgical process to remove the tumor/clot/abscess 
  • A surgical process is done to drain the fluids through a hole in the skull 
  • Osmotic therapy or diuretics 
  • Procedure to reduce swelling 
  • Surgery to make more space in the skull