Herniations Flashcards

1
Q

are patients conscious with herniations?

A

NEVER

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2
Q

name the four types of brain herniations

A

uncal
central
tonsillar
cingulate

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3
Q

where does a cingulate brain herniation occur?

A

supratentorial portion of the brain

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4
Q

a cingulate supratentorial herniation leads to what change in CSF?

A

ventricles become compressed

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5
Q

how does cingulate herniation lead to coma and death?

A

it actually causes a downward central herniation then uncal herniation and ultimately a tonsillar herniation and these can compress the brain stem

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6
Q

what artery is at risk with cingulate herniation?

A

ACA

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7
Q

ACA ischemia in cingulate hernation causes what symptom?

A

weakness of contralateral leg

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8
Q

where is a central (transtentorial) herniation located?

A

mid region of brain on side usually

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9
Q

what does a central herniation lead to with brainstem?

A

caudal displacement of diencephalon, midbrain and pons

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10
Q

what does a central herniation cause with vessels?

A

stretches/shears paramedian perforating vessels (branches of basilar)

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11
Q

what can the shearing/stretching of perforating vessels in a central herniation lead to?

A

duret hemorrhages

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12
Q

what is a duret hemorrhage?

A

small hemorrhage in the midbrain or pons

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13
Q

what herniation leads to duret hemorrhage

A

central transtentorial herniation

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14
Q

what will you see on CT with duret hemorrhage?

A

small white area in middle of cortex

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15
Q

where is an uncal herniation found?

A

medial temporal lobe on same side as lesion

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16
Q

where does an uncal herniation go?

A

into tentorial notch of the tentorium cerebelli

17
Q

what does an uncal herniation compress? 2 things

A

ipsilateral midbrain and ipsilateral CN III

18
Q

what are symptoms of uncal herniation? 3 things

A

contralateral weakness of motor movement
dilated ipsilateral pupil
decreased level of consciousness

19
Q

what is a tonsillar herniation?

A

herniation of tonsils of cerebellum out foramen magnum

20
Q

what does tonsillar herniation compress?

A

brainstem

21
Q

what does tonsillar herniation lead to?

A

flaccidity in muscles, coma, changes in respirations, pulse and BP