Paradoxical cerebral herniation
secondary to lumbar puncture after decompressive craniectomy for a large space-occupying hemispheric stroke: Case report.
Craniectomies larger than 12 cm as in our study less likely to cause effects of external cerebral herniation
such as cortical vein compression and cortical laceration resulting in venous infarction of herniated brain tissue and cortical damage.
A large defect at the site of the right parietal skull fracture was noted with evidence of external cerebral herniation
into the subgaleal space.
Xigris is already contraindicated in patients with active internal bleeding, recent hemorrhagic stroke, recent intracranial or in traspinal surgery or severe head trauma, trauma with an in creased risk of life-threatening bleeding, presence of an epidural catheter, and intracranial neoplasm or mass lesion or evidence of cerebral herniation
A computed tomography (CT) scan and magnetic resonance imaging performed the next morning showed blood clots in the brain, with complete occlusion of the superior sagittal sinus vein, and cerebral herniation
(1,2) Allergic reactions to alteplase include anaphylactic reaction, laryngeal edema, orolingual angioedema, rash, uticaria, cerebral edema, cerebral herniation
, and seizures.
Neurologic imaging indicated findings consistent with a subarachnoid hemorrhage, which expanded rapidly in the 48 hours after admission, leading to cerebral herniation
Surgical intervention may include decompressive hemicraniectomy to allow for space additional swelling to reduce the risk of cerebral herniation
. Once these options have been optimized, hypothermia is emerging as the next intervention along the treatment spectrum.
has been reported in 5% of patients with ABM, resulting in mortality in 30% of the cases.20 Although a CT scan of the head is useful to look at the contraindications to lumbar puncture (LP), but a normal CT scan does not mean that it is safe to perform LP.
Complications includes; Neurological deficits, Seizures Hydrocephalus, Spasticity, Urinary complications ,Deep venous thrombosis (DVT),Pulmonary emboli, Cerebral herniation
, Loss of cognitive function, Loss of movement of arm(s) or leg(s),dysphagia, dysphasia, vision loss etc.