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Tonsillar Herniations (tonsillar + herniation)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Cerebellar Tonsillar Herniation After Weight Loss in a Patient With Idiopathic Intracranial Hypertension

HEADACHE, Issue 1 2010
Jerome J. Graber MD
(Headache 2010;50:146-148) Acquired cerebellar tonsillar herniation is a known complication of lumboperitoneal shunt (LPS) for any indication, including idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri.1 While the underlying pathophysiology of IIH remains unknown, increasing body mass index is a clear risk factor for the development of IIH. We describe an obese patient with IIH unresponsive to LPS who developed symptoms of intracranial hypotension and cerebellar tonsillar herniation after bariatric surgery and a 50-kg weight loss. [source]

Peculiar venous lesions in fatal hyponatremic brain edema

NEUROPATHOLOGY, Issue 1 2005
Makoto Nishie
A 19-year-old woman with a 3-year history of schizophrenia suddenly began to vomit, and rapidly developed a coma an hour after the onset of vomiting. A brain CT scan showed diffuse brain edema with compression of the ventricles. Laboratory tests showed a low serum sodium concentration of 117 mmol/L. She died 67 h after the onset of the first symptom. A postmortem examination showed diffuse swelling of the brain with bilateral uncal and tonsillar herniations. Histologically, no necrotic, hemorrhagic or encephalitic changes were seen. However, microvacuolar changes with lymphocytic infiltration were found in the venous walls (media and adventitia) mainly in the basal ganglia, thalamus and brainstem. To our knowledge, this is the first demonstration of venous alterations in fatal hyponatremic brain edema. These changes may have participated in the exacerbation of the brain edema due to functional disturbance of venous drainage. [source]

Brain herniations in patients with intracerebral hemorrhage

ACTA NEUROLOGICA SCANDINAVICA, Issue 4 2009
J. Kalita
Objectives,,, To study the types, frequency and clinical correlates of brain herniations in patients with intracerebral hemorrhage (ICH). Methods,,, In 24 patients with ICH (putaminal 22 and thalamic 2) features of raised intracranial pressure (ICP), such as hyperventilation, extensor rigidity, pupillary asymmetry and pyramidal signs on the non-hemiplegic side, were recorded. Depth of coma was assessed by using the Glasgow Coma Scale (GCS) and severity of stroke by using the Canadian Neurological Scale (CNS). On MRI, evidence of herniation, horizontal and vertical shifts and the edema,hematoma complex were measured and compared with that of 15 matched controls. The clinical signs of herniation correlated with radiological parameters. Results,,, The mean age of the patients was 57.7 years, six of them were women. Cerebral herniations were present in 11 (46%) patients. Subfalcian herniation (in six) was the commonest followed by uncal (in three). Combination of subfalcian and uncal herniations was present in one and subfalcian, uncal and tonsillar herniations in another. Herniations had significant correlation with the GCS, pupillary abnormalities, cortical atrophy, hematoma size and the edema,hematoma complex. One-month mortality was related to the GCS score, pupillary abnormalities and the edema,hematoma complex. Horizontal shift was related to the GCS score. Conclusion,,, In patients with ganglionic ICH, subfalcian herniation was the commonest. Herniation was associated with increased mortality. Horizontal shift correlated with clinical features of raised ICP and outcome. [source]