Herniation syndrome; Transtentorial herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain

Brain herniation is a medical emergency. The goal of treatment is to save the patient's life.

To help reverse or prevent a brain herniation, the medical team will treat increased swelling and pressure in the brain. Treatment may involve:

• Placing a drain into the brain to help remove fluid
• Corticosteroids, such as dexamethasone, especially if there is a brain tumor, to reduce swelling
• Medications that remove fluid from the body, such as mannitol or other diuretics, which reduce pressure inside the skull
• Placing a tube in the airway (endotracheal intubation) and increasing the breathing rate to reduce the levels of carbon dioxide (CO2) in the blood
• Removing blood or blood clots if they are raising pressure inside the skull and causing herniation

The outlook varies and depends on where in the brain the herniation occurrs. Without treatment, death is likely.

A brain herniation often causes a massive stroke. There can be damage to parts of the brain that control breathing and blood flow. This can rapidly lead to death or brain death.

• Brain death
• Permanent and significant neurologic problems

Call your local emergency number (such as 911) or take the patient to a hospital emergency room if he or she develops decreased alertness or other symptoms, especially if there has been a head injury or if the person has a brain tumor or blood vessel problem.

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Review Date: 09/13/2010
Reviewed By: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)