Can patients with brain herniation on cranial computed tomography have a normal neurologic exam?

Academic Emergency Medicine

Volumn 16, Issue 2, 2009, Pages 145-150

  Probst, Marc A ^a   Baraff, Larry J ^a   Hoffman, Jerome R ^a   Wolfson, Allan B ^b   Ourian, Ariel J ^a   Mower, William R ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

Author keywords

Brain shift; Computer tomography (CT) imaging; Herniation; Mass effect; Neurologic examination

Indexed keywords

ADOLESCENT; ADULT; AGED; ARTICLE; BRAIN HERNIA; COMPUTER ASSISTED TOMOGRAPHY; DATA BASE; EMERGENCY WARD; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; NEUROIMAGING; NEUROLOGIC DISEASE; NEUROLOGIC EXAMINATION; OBSERVATIONAL STUDY; OUTCOME ASSESSMENT; PATIENT INFORMATION; PRIORITY JOURNAL; PROSPECTIVE STUDY; SECONDARY ANALYSIS; SKULL RADIOGRAPHY;

ADULT; ENCEPHALOCELE; FEMALE; GLASGOW COMA SCALE; HUMANS; MALE; MIDDLE AGED; NEUROLOGIC EXAMINATION; TOMOGRAPHY, X-RAY COMPUTED;

EID: 59949105814     PISSN: 10696563     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1553-2712.2008.00312.x     Document Type: Article

References (22)

1. Korein J, Cravioto H, Leicach M. Reevaluation of lumbar puncture; a study of 129 patients with papilledema or intracranial hypertension. Neurology. 1959; 9:290-7.
2. Duffy GP. Lumbar puncture in the presence of raised intracranial pressure. Br Med J. 1969; 1:407-9.
3. Duffy GP. Lumbar puncture in spontaneous subarachnoid hemorrhage. Br Med J. 1982; 285:1163-4.
4. Archer B. Computed tomography before lumbar puncture in acute meningitis: a review of the risks and benefits. Can Med Assoc J. 1993;148:961-5.
5. Rennick G, Shann F, de Campo J. Cerebral herniation during bacterial meningitis in children. Br Med J. 1993; 306:953-5.
6. Aghayev E, Yen K, Sonnenschein M, et al. Virtopsy post-mortem multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) demonstrating descending tonsillar herniation: comparison to clinical studies. Neuroradiology. 2004; 46:559-64.
7. Ropper AH. Lateral displacement of the brain and level of consciousness in patients with an acute hemispheral mass. N Engl J Med. 1986; 314:953-8.
8. Van Crevel H, Hijdra A, de Gans J. Lumbar puncture and the risk of herniation: when should we first perform CT? J Neurol. 2002; 249:129-37.
9. Joffe A. Lumbar puncture and brain herniation in acute bacterial meningitis: a review. J Intensive Care Med. 2007; 22:194-207.
10. Munro D, Sisson WR. Hernia through the incisura of the tentorium cerebelli in connection with craniocerebral trauma. N Engl J Med. 1952; 247:699-709.
11. Zervas NT, Hedley-Whyte J. Successful treatment of cerebral herniation in five patients. N Engl J Med. 1972; 286:1075-7.
12. Plum F, Posner J. The Diagnosis of Stupor and Coma. 3rd ed. Philadelphia: F. A. Davis, 1980.
13. Maramattom BV, Wijdicks EF. Uncal herniation. Arch Neurol. 2005; 62:1932-5.
14. Fisher CM. Brain Herniation: A revision of classical contents. Can J Neurol Sci. 1995; 22:3-91.
15. Pannullo SC, Reich JB, Krol G, Deck MD, Posner JB. MRI changes in intracranial hypotension. Neurology. 1993; 43:919-26.
16. Mower WR, Hoffman JR, Herbert M, et al. NEXUS II Investigators National Emergency X-Radiography Utilization Study: developing a clinical decision instrument to rule out intracranial injuries in patients with minor head trauma: methodology of the NEXUS II investigation. Ann Emerg Med. 2002; 40:505-14.
17. Gilbert EH, Lowenstein SR, Koziol-McLain J, Barta DC, Steiner J. Chart reviews in emergency medicine research: where are the methods? Ann Emerg Med. 1996; 27:305-8.
18. Fleiss JL, Levin B, Paik MC. Statistical Methods for Rates and Proportions. 3rd ed. Hoboken (NJ): Wiley, 2003.
19. Smith A, Shah G A, Kron T. Variation of patient dose in head CT. Br J Radiol. 1998; 71:1296-301.
20. Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure. N Engl J Med. 2007; 357:2277-84.
21. Osborn AG. Diagnosis of descending transtentorial herniation by cranial computed tomography. Radiology. 1977; 123:93-6.
22. Osborn AG, Heaston DK, Wing SD. Diagnosis of ascending transtentorial herniation by cranial computed tomography. Am J Roentgenol 1978; 130:755-60.