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• 5 Brain and Environs: Cranium, Ventricles, and Meninges

• 5.2 Intracranial Mass Lesions

• What is a mass effect?

  any distortion of normal brain geometry, different sizes of impact.

• What are the causes of neurological symptoms of tumors, hemorrhages, accesses, hydrocephalus etc.

  - compressions & destruction brain
  - ICP
  - mass lesions can displace CNS structure: herniation

• 5.4 Brain Herniation Syndromes

• What is a brain herniation syndrome?

  when a mass effect is severe enough to push intracranial structures from one apartment to the other

• What happens after an transtentorial herniation (herniation of medial temporal lobe?

  blown pupil, hemiplegia, coma, compression ipsilateral to lesion = eye movement impairment, compression contralateral to lesion - hemiplegia

• What is Kernohan's phenomenon?

  Midbrain pushed all the way over until it is compressed by the opposide side of the tectorial notch.

• What happens after a central herniation (downward displacement brainstem)

  ICP (hydrocephalus & cerebral edema)

• What is a tonsillar herniation?

  Herniation cerebellar tonsils downward through the formate magnum. Respiratory arrest, blood pressure instability, death

• What happens after a subfalcine herniation?

  cingulate gyrus and other brain structures herniate under fall cerebri --> sometimes infarcts

• 5.6 Intracranial Hemorrhage

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• What happens during a Epidural Hematoma?

  rapidly expanding, peels dura away from inner surface of the skull, does not spread past cranial structures where dura lies tight around the skull
  Initially no symptoms, after few ours brain tissue compressed causing ICP

• What happens during a Subdural Hematoma?

  rupture of riding veins, wide spreading.