RT Book, Section
A1 Stark, Christopher L.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1186300057
T1 Herniation Syndromes
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1186300057
RD 2024/04/24
AB Severe  head  injury  can  result  in  extra-axial  hematoma,  cerebral  contusion,  or  diffuse  cerebral  edema,  which,  in  turn,  may  cause  one  of  five  brain  herniation  syndromes:  uncal,  central  transtentorial,  cerebellotonsillar,  subfalcine,  and  external.  Uncal  herniation  occurs  when  the  uncus  of  the  temporal  lobe  is  displaced  inferiorly  through  the  medial  edge  of  the  tentorium.  Compression  of  cranial  nerve  III  can  cause  an  ipsilateral  dilated  pupil.  Typically,  patients  with  uncal  herniation  are  unconscious  and  require  intubation.  A  contusion  to  the  eye  may  also  result  in  a  dilated,  nonresponsive  pupil  and  arouse  suspicion  for  uncal  herniation,  but  typically  these  patients  are  alert.