Clinical manifestations of brain herniation

Brain herniation is a brain disease. The most common cause of this disease is foreign matter in the brain or intracranial hematoma. After becoming ill, there are actually many clinical symptoms that can serve as a reminder to everyone. The most common and obvious symptom is changes in the pupils. When brain herniation occurs, there will be a significant difference in the size of the patient's pupils on both sides, and the response to light will also become weaker.

1. Symptoms of increased intracranial pressure: severe headache and frequent vomiting, which are more severe than before brain herniation, and irritability.

2. Changes in consciousness: manifested as drowsiness, light stupor or even coma, and slow or absent response to external stimuli.

3. Pupillary changes: The pupils on both sides are not of equal size. At the beginning, the pupil on the affected side is slightly smaller and the light reaction is slightly slower. Later, the pupil on the affected side gradually dilates and becomes slightly irregular. Direct and indirect light reactions disappear, but the pupil on the other side may still be normal. This is because the oculomotor nerve on the affected side is compressed and pulled. In addition, the affected side may also experience ptosis, exotropia, etc. If brain herniation continues to develop, bilateral pupil dilation and disappearance of light response may occur, which is caused by compression of the oculomotor nerve nucleus in the brainstem, leading to dysfunction.

4. Movement disorders: mostly occur on the opposite side of the dilated pupil, manifested as reduced or absent voluntary movement of the limbs. The continued development of brain herniation causes symptoms to spread to both sides, causing weakness in the limbs or intermittent head and neck tilting back, limbs straightening, and back hyperextension in opisthotonos, which is called decerebrate rigidity and is a characteristic manifestation of severe brainstem damage.

5. Disorders of vital signs: manifested as changes in blood pressure, pulse, respiration, and body temperature. In severe cases, blood pressure fluctuates, breathing becomes fast and slow, the face becomes flushed and sweats profusely, and sometimes the patient becomes pale and sweats. The body temperature may be as high as 41°C or as low as 35°C without rising. Finally, breathing stops, and the blood pressure drops and the heart stops beating, leading to death.