Chapter 1 – Brain Herniation

Brain herniation is the displacement of brain tissue through the rigid dural folds (i.e., falx and tentorium) or skull openings (e.g., foramen magnum). Although patients with chronic brain herniation associated with developmental defects, such as Arnold–Chiari malformation, may remain asymptomatic for many years, acute brain herniation following neurosurgery is a catastrophic event that results in mechanical and vascular damage of the brain. In many circumstances, brain herniation is often regarded as a terminal event. The purpose of this chapter is to describe the mechanisms, classifications, clinical effects, prevention, and treatment of brain herniation after neurosurgery.