Talk:Brain herniation

Diagram
I just made the diagram in the classification section, I hope people will let me know if there's any problem with it or any improvements that could be made (aesthetic or factual). delldot  talk  21:20, 5 March 2008 (UTC)

Uncal Herniation
I'm new, and I don't want to edit without passing this by someone, but I don't believe this line to be correct, "Since the corticospinal tract predominately innervates flexor muscles, extension of the leg may also be seen." The cortical spinal tract can operate almost every muscle in the body, I believe the author of this section meant to talk about the vestibulospinal and reticulospinal tracts, which are primarily responsible for extension of limbs. These are ordinarily inhibited by the cerebral cortex. This is why with both decorticate and decerebrate posturing you see extension of the lower limbs. Variablistic (talk) 07:25, 1 September 2010 (UTC)

Compression
Brain compression, also referred to simply as "compression" redirects here. Should we add these terms as synonyms to the lead? Rich Farmbrough, 22:33, 14 October 2012 (UTC).


 * If you're asking whether compression is a synonym of herniation, it isn't. Herniation occurs when compression is severe enough to cause the membranes that protect the brain to rip or tear.  In other words, herniation is a possible consequence of compression. Looie496 (talk) 23:01, 14 October 2012 (UTC)
 * (edit conflict). Yes, exactly so. They aren't really synonyms. Herniation is one effect of compression, but is not always seen. Think of squeezing a tube of toothpaste. If you don't squeeze too hard, nothing happens. But at some point, and especially if you remove the cap, toothpaste comes out of the tube. When some semisolid brain squirts out or bulges out into some compartment where it's nto supposed to be, under pressure, that's herniation. If it doesn't, it's not. S  B Harris 23:04, 14 October 2012 (UTC)
 * I'm puzzled by some of the responses above - concepts are being mingled in non-standard ways. In the context of brain herniation, tearing of meninges is not a prerequisite. Brain herniation is the movement of brain tissue, with deformation, past a restrictive barrier (e.g. a falx or foramen).  In contrast, brainstem compression can occur as a result of herniation, if the herniated tissue compresses the brainstem (e.g. as a result of tonsillar herniation).  There are other compression syndromes - of nerves, blood vessels, etc - that may result from herniation or other processes such as epidural abscess, Arnold-Chiari malformation, etc.  Herniation and compression are not synonyms.  -- Scray (talk) 00:13, 15 October 2012 (UTC)


 * Thanks for the responses, since compression can cause or be caused by herniation, or not, should we then have a separate article on brain compression? Rich Farmbrough, 00:51, 15 October 2012 (UTC).


 * I think a separate article is reasonable (there are many potential causes and sequelae). The term is not often used in a clinical context; for example, if one searches Pubmed for phrases in titles, you get an indication of usage: brain compression (41 articles); in comparison, intracranial hypertension (2224 articles).  -- Scray (talk) 01:23, 15 October 2012 (UTC)
 * Cerebral contusion - an important sequela of brain compression - is also highly relevant. -- Scray (talk) 01:26, 15 October 2012 (UTC)

I do not believe that meningeal tearing is a requirement for herniation. Moreover, meningeal tearing alone is insufficient to define herniation.

(Acquired) herniation will not occur in the absence of compression, although the phrase "brain compression" is not commonly used. Arnold–Chiari malformation is an unusual situation where herniation occurs congenitally and leads to blockage of CSF flow.

The phrase "raised intracranial pressure" is the commonly-used phrase that describes the state preceding herniation. Indeed the potential for herniation is the reason why raised ICP is so dangerous. [Disclosure: I am a pulmonologist.] Axl  ¤  [Talk]  17:36, 15 October 2012 (UTC)

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