Brain herniation is a deadly side effect of very high intracranial pressure that occurs when a part of the brain is squeezed across structures within the skull. The brain can shift across such structures as the falx cerebri, the tentorium cerebelli, and even through the foramen magnum in the base of the skull (through which the spinal cord connects with the brain). Herniation can be caused by a number of factors that cause a mass effect and increase intracranial pressure (ICP): these include traumatic brain injury, intracranial hemorrhage, or brain tumor.
Herniation can also occur in the absence of high ICP when mass lesions such as hematomas occur at the borders of brain compartments. In such cases local pressure is increased at the place where the herniation occurs, but this pressure is not transmitted to the rest of the brain, and therefore does not register as an increase in ICP.
Because herniation puts extreme pressure on parts of the brain and thereby cuts off the blood supply to various parts of the brain, it is often fatal. Therefore, extreme measures are taken in hospital settings to prevent the condition by reducing intracranial pressure, or decompressing (draining) a hematoma which is putting local pressure on a part of the brain.
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... Brain herniation can cause severe disability or death ... In fact, when herniation is visible on a CT scan, the prognosis for a meaningful recovery of neurological function is poor ... paralyzed on the same side as the lesion causing the pressure, or damage to parts of the brain caused by herniation may cause paralysis on the side opposite the lesion ...
... Such conditions include traumatic brain injury, stroke, intracranial hemorrhage, brain tumors, and encephalopathy ... Diseases such as malaria are also known to cause the brain to swell and cause this posturing effect ... and decorticate posturing can indicate that brain herniation is occurring or is about to occur ...
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