Brain herniation is a potentially deadly side effect of very high pressure within the skull 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 the hole 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.
Professional Reference articles are designed for health professionals to use. You may find the Subdural Haematoma article more useful, or one of our other health articles. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. The meninges are the connective tissue membranes that line the skull and vertebral canal. They enclose the brain and spinal cord.
Subacute or chronic subdural hematomas often occur in patients who have brain atrophy, a shrinking or wasting away of brain tissue due to age, trauma, or disease, which results in a slow accumulation of blood over several days to weeks or months. The standard surgical treatment involves drilling a hole in the skull, or opening a larger portion of the skull, to drain the hematoma. This relieves increasing pressure on the brain that can cause debilitating symptoms such as severe headaches, profound body weakness, vision and speech problems, confusion, and impaired memory. However, recurrent subdural hematomas frequently require repeat surgeries that pose risks — especially for more fragile older patients or others with underlying diseases, who may not be good candidates for open surgery. Charles J.
According to a study completed at the Helsinki University Hospital Department of Neurosurgery, even patients over the age of 75 may recover from severe traumatic brain injury. This is the first study to describe the results of surgically treated elderly patients with acute subdural hematomas. It is generally accepted that elderly patients who suffer from an acute subdural hematoma should not be treated surgically, as few survive and even fewer recover to an independent life. However, the world's population is rapidly aging leading to an increased rate of fall accidents.
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