Encephalocele

When outlined within the cranial cavity with a sub-occupying lesions, the sub-cavity pressure than neighboring sub-cavity pressure, brain tissue from the high-pressure area to area of low pressure shift, which led to a series of clinical syndrome, known as cerebral hernia. Supratentorial brain tissue (temporal lobe of the hippocampus, hooked back) cerebellar tentorium check to the screen, known as the cerebellar tentorium hernia or temporal lobe hernia. Screen under the cerebellar tonsil and medulla by the foramen magnum check to the canal, known as the foramen magnum hernia or cerebellar tonsil hernia. Side of the cerebral hemisphere as sickle cingulate has been squeezed into the hole under the contralateral pm cavity, known as the falx hernia or cingulate hernia. Etiology and Pathogenesis of intracranial pathology any larger lesions caused cranial pressure at the uneven distribution can cause cerebral hernia. Supratentorial lesions were caused cerebellar tentorium hernia, the lesions were caused screen under the foramen magnum hernia. Herniation caused by the common diseases are : ① damage caused by intracranial hematoma, such as acute subdural hematoma, subdural hematoma, intracerebral hematoma; ② various intracranial tumors especially those located in the side of the cerebral hemisphere tumor and posterior fossa neoplasms; ③ intracranial abscess; ④ intracranial parasitic diseases and other chronic granulomatous. In these lesions on the basis of who make some additions to man-made factors, such as lumbar puncture for the release of excess cerebrospinal fluid, make cranial and spinal between on-screen and screen cavity-cavity under pressure difference between the increase, it will promote the formation of brain herniation. Iatrogenic factors such as the herniation, clinicians should be avoided. Clinical manifestations (1) cerebellar tentorium a hernia. Intracranial hypertension symptoms : severe headache for the performance and frequent vomiting, its extent than before herniation been exacerbated, and irritability. 2. Change in consciousness : the performance of drowsiness, coma and even coma shallow, right outside stimuli slow response or disappeared. 3. Pupillary changes : from both sides of the pupil, at the beginning of the pupil on the side of slightly narrowed slightly slow-response later on the side of the pupil gradually dispersed. slightly irregular, direct and indirect light reaction disappear, but still normal contralateral pupil. This is due to the affected stretch oculomotor oppression about it. Moreover, the affected side can be dangerous to sag, and so on ramps outside the eyeball. If herniation continue to develop, there may be bilateral Mydriasis, light reaction disappeared, This is within the brainstem compression nuclear oculomotor nerve dysfunction induced by arch [onwards. 4. Dyskinesia : Most occurred in mydriasis and the contralateral side, the performance of physically independent activity decreased or disappeared. Encephalocele so that the continued development of bilateral symptoms affected, the strength, impaired limbs caused intermittent or appeared neck backwards, limbs straighten footer memorized stretch was opisthotonus-called tonic to the brain is severely damaged brain stem characteristic performance. 5. Vital signs of disorder : performance of blood pressure, pulse, respiration and temperature changes. Serious blood pressure goes up, breathing unsteadiness, sometimes looking flushes, perspiration dripping, sometimes to pale, Khan closed, body temperature can be as high as 41 ° C or above, they may be as low as 35 ° C or not, the final stop breathing, blood pressure drop finally, died of cardiac arrest. (2) foramen magnum hernia : patients often only severe headache, vomiting repeatedly, and the vital signs of disorder neck stiffness, pain, Consciousness is a late change, no change in pupil respiratory arrest occurred earlier. (3) the falx hernia : disease caused ipsilateral hemisphere side pressure within the Ministry of softening of the brain tissue necrosis, there contralateral leg paraparesis. voiding dysfunction, and other symptoms. Inspection wellness checks. CT. Herniation treatment of increased intracranial pressure caused by the serious situation, we must make emergency