MIGS, PAKI-AYOS NALANG YUNG FIGURE NUMBERS. Uncus and parahippocampal gyrus shift across the tentorial
THANKS! notch or free edge of tentorium cerebelli, leads to
→ Compressed midbrain
IV. TYPES OF BRAIN HERNIATION → Displaced posterior cerebral artery (PCA)
→ Compressed CN III (from the displaced PCA over it)
Compressed ipsilateral cerebral peduncle -> contralateral
hemiparesis
In some cases, Kernohan’s syndrome (a false localizing sign),
an ipsilateral hemiparesis, is caused by contralateral cerebral
peduncle over Kernohan’s notch.
Decreased sensorium due to distortion of ARAS in midbrain
Compressed ipsilateral PCA -> ischemia of ipsilateral primary
visual cortex and contralateral visual field deficit.
CN III compression -> ipsilateral pupillary dilation followed by
oculomotor nerve palsy wherein patient’s eye deviates in a down
and out position.
Progressive uncal herniation -> brainstem distortion -> duret
hemorrhage in median and paramedian zones of midbrain and
Figure #. Diagram of Brain Herniations. A. Subfalcine = 3, B Uncal = 1, C. pons -> decorticate posturing, Cushing’s triad (hypertension +
Central = 2, D. Tonsillar = 6. Other herniations = Transcalvarial and bradycardia + bradyapnea), respiratory arrest, and death
Upward.
C. CENTRAL HERNIATION
A. SUBFALCINE HERNIATION
END OF TRANS