Diagnosis of Descending Transtentorial Herniation by Cranial Computed Tomography

Abstract

Descending transtentorial herniation (DTH) [in man] secondary to a supratentorial mass effect was detected by CT [computed tomography]. Early signs of uncal herniation included encroachment on the suprasellar cistern, displacement of the brain stem, enlargement of the ipsilateral crural subarachnoid space and compression of the contralateral cerebral peduncle. Increasingly severe combined uncal and hippocampal DTH resulted in progressive obliteration of the suprasellar and interpeduncular cisterns, elongation or compression of the brain stem and inferior or posterior displacement of the basilar artery.