Document Detail


Upward transtentorial herniation: seven cases and a literature review.
MedLine Citation:
PMID:  485890     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Seven cases of upward transtentorial herniation occurred. In each patient, coma with reactive, miotic pupils, asymmetrical or absent caloric responses, and decerebrate posture indicated brain-stem compression. In this setting, the development of unequal, then midposition, fixed pupils signaled midbrain failure from upward herniation. Vertebral angiography showed upward displacement of the superior cerebellar arteries. Results of autopsy confirmed the existence of grooving of the vermis by the tentorial margins and, in one case, of anterior displacement and distortion of the midbrain. In five of 45 reported cases of upward herniation, the conditions were diagnosed antemortem. Instances of cerebellar hematoma and tumor predominated. In at least seven patients, performance of ventriculography may have precipitated herniation. Clinical details were provided in only nine patients and did not separate upward herniation from brain-stem compression. Cerebellar ischemic infarct found in one of our patients is a rarely reported cause of upward herniation.
Authors:
R A Cuneo; J J Caronna; L Pitts; J Townsend; D P Winestock
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  36     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  1979 Oct 
Date Detail:
Created Date:  1979-11-28     Completed Date:  1979-11-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  618-23     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerebellar Diseases / etiology,  pathology*,  radiography
Cerebellum / pathology*,  radiography
Encephalocele / etiology,  pathology*,  radiography
Female
Humans
Male

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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