Subfalcine herniation

Subfalcine Herniation is a type of brain herniation that occurs when part of the brain shifts from one side to the other, under the falx cerebri, a sickle-shaped fold of dura mater in the brain. This condition is a serious and potentially life-threatening complication often associated with increased intracranial pressure (ICP), which can be caused by various factors such as head injury, brain tumor, stroke, or inflammation.

Causes

Subfalcine herniation is typically triggered by an increase in intracranial pressure that results from a mass effect. This mass effect can be due to conditions such as tumors, abscesses, hematomas, or cerebral edema. As the pressure increases on one side of the brain, it pushes brain tissue beneath the falx cerebri towards the opposite hemisphere.

Symptoms

The symptoms of subfalcine herniation can vary depending on the severity and the rate of herniation. Common symptoms include headache, nausea, vomiting, confusion, and consciousness changes ranging from drowsiness to coma. Neurological deficits may also occur, including weakness or paralysis on one side of the body, known as hemiparesis.

Diagnosis

Diagnosis of subfalcine herniation is primarily based on neuroimaging techniques such as CT scans or Magnetic Resonance Imaging (MRI). These imaging modalities can show the displacement of brain tissue and help assess the underlying cause and extent of the herniation.

Treatment

Treatment of subfalcine herniation focuses on reducing the intracranial pressure and addressing the underlying cause. This may involve the use of medications such as diuretics to reduce brain swelling, corticosteroids to decrease inflammation, and anticonvulsants to prevent or control seizures. In some cases, surgical intervention may be necessary to remove the source of the increased pressure, such as a tumor or hematoma.

Prognosis

The prognosis for individuals with subfalcine herniation varies and depends on the speed of diagnosis, the underlying cause, and the effectiveness of treatment. Early detection and treatment are crucial for a favorable outcome. Without prompt intervention, subfalcine herniation can lead to significant brain damage, neurological deficits, and even death.

See Also

• Brain herniation
• Intracranial pressure
• Cerebral edema
• Hematoma
• Falx cerebri