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Brain herniations in patients with intracerebral hemorrhage

J Kalita1, U K Misra, A Vajpeyee

  • 1Department of Neurology, Sanjay Gandhi PGIMS, Lucknow, India. jayanteek@yahoomail.com

Acta Neurologica Scandinavica
|December 5, 2008
PubMed

Insights

Subfalcian herniation is common in intracerebral hemorrhage (ICH). Brain herniation in ICH patients is linked to worse outcomes and increased mortality, with horizontal shift correlating to clinical signs.

Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Intracerebral hemorrhage (ICH) can lead to increased intracranial pressure (ICP) and brain herniation.
  • Understanding the types and clinical impact of herniation is crucial for patient management.

Purpose of the Study:

  • To investigate the types, frequency, and clinical associations of brain herniations in patients with intracerebral hemorrhage (ICH).

Main Methods:

  • 24 patients with ICH underwent MRI to assess herniation, shifts, and edema-hematoma complex.
  • Clinical data including Glasgow Coma Scale (GCS) and Canadian Neurological Scale (CNS) were recorded.
  • Radiological findings were compared to 15 matched controls.

Main Results:

  • Cerebral herniations were observed in 46% of ICH patients, with subfalcian herniation being the most frequent.
  • Herniations showed significant correlation with GCS, pupillary abnormalities, cortical atrophy, hematoma size, and the edema-hematoma complex.
  • One-month mortality was associated with GCS score, pupillary abnormalities, and the edema-hematoma complex.

Conclusions:

  • Subfalcian herniation is the most common type in ganglionic ICH.
  • Brain herniation in ICH is associated with increased mortality.
  • Horizontal brain shift correlates with clinical signs of raised ICP and patient outcomes.
Abstract

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