COMPLETE REVERSAL OF TRANS-TENTORIAL AND SUB-FALCINE BRAIN HERNIATION WITH CRANIECTOMY: A SUCCESSFUL CASE REPORT

R PERVAIZ; T HAFEEZ; N RAZA; A RAZA; S AQEEL; MJ SHAHID; M AHMED; SMZU ABEDIN; A ASHRAF; A RUBEET

doi:10.54112/pjicm.v4i02.32

Authors

R PERVAIZ 1Department of Medicine and Critical Care, Bahria International Hospital, Lahore, Pakistan
T HAFEEZ 1Department of Medicine and Critical Care, Bahria International Hospital, Lahore, Pakistan
N RAZA Department of Neurosurgery, Bahria International Hospital, Lahore, Pakistan
A RAZA Department of Radiology, Bahria International Hospital, Lahore, Pakistan
S AQEEL Department of Radiology, Bahria International Hospital, Lahore, Pakistan
MJ SHAHID Department of Radiology, Bahria International Hospital, Lahore, Pakistan
M AHMED Research and Innovation, Department of Critical Care Medicine, Bahria International Hospital, Lahore
SMZU ABEDIN Department of Medicine and Critical Care, Bahria International Hospital, Lahore, Pakistan
A ASHRAF Research and Innovation, Department of Critical Care Medicine, Bahria International Hospital, Lahore
A RUBEET Research and Innovation, Department of Critical Care Medicine, Bahria International Hospital, Lahore

DOI:

https://doi.org/10.54112/pjicm.v4i02.32

Keywords:

Brain Herniation, Glioblastoma Multiforme, Intracranial Pressure

Abstract

Introduction: Brain herniation, or brain code, is a critical condition caused by elevated intracranial pressure, leading to abnormal brain tissue protrusion. Chronic herniations may be linked to developmental defects and remain asymptomatic, while acute herniations are life-threatening, especially after neurosurgery. Case Presentation: A 25-year-old female with Glioblastoma multiforme presented with facial weakness. Initially suspected as Bell’s Palsy, her condition rapidly worsened, leading to coma and signs of raised intracranial pressure. A CT scan revealed a brain tumor with associated edema, hemorrhage, and multiple herniations. Emergency craniectomy and subsequent medical management showed initial improvement, but she later developed ischemia and infarction, resulting in her death. Discussion: Timely diagnosis and intervention are crucial in managing brain herniation. Clinical signs and cranial nerve assessments are vital for diagnosis. Management focuses on reducing intracranial pressure through medical and surgical means. Early intervention is key to better outcomes, though the prognosis can be poor due to underlying conditions like Glioblastoma multiforme. Conclusion: Effective management of brain herniation requires timely surgical and medical intervention. This case illustrates the rapid progression and complexity of brain herniation, emphasizing the importance of early and comprehensive treatment.

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