ascending transtentorial herniation

Ascending transtentorial herniation is a situation where space-occupying lesions in the posterior cranial fossa cause superior displacement of superior parts of the cerebellum through the tentorial notch.

Clinical presentation

• nausea and/or vomiting 
• rapid progression toward a decreased level of consciousness and, eventually, death

Radiographic features

General imaging features include:

• flattening or reversal of the smile-shaped quadrigeminal cistern
• obliteration of the quadrigeminal and superior cerebellar cistern in severe cases
• "spinning top" appearance of midbrain due to bilateral compression of the posterior aspect of the midbrain
• may be associated with an infarct in the territory of posterior cerebral and superior cerebellar arteries due to arterial compression
• hydrocephalus as the result of the pressure of the cerebellum on the cerebral aqueduct

Siehe auch:

• brain herniation
• transtentorielle Herniation

und weiter:

• uncal herniation
• Einklemmung
• acquired intracranial herniation
• Einklemmung Foramen magnum