 |  transtentorial herniation
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| Author | 10 Posts |
nadiabarati
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in transtentorial herniation we have: ipsilateral CN III palsy, ipsilateral hemiparalysis, contalateral homonymous hemianopia
Am I right? or better say is HY neuroanatomy right????
Please let me know I'm so confused about this damn transtentorial herniation....
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| smal
Forum Guru
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Posts: 727
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i think u r rt.
its the herniation of brainstem,so we expect all the fibers to 've crossed and uncrossed.
hence the lesions
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| Cedrick
Forum Fanatic
Topics: 322
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Does it give more specifics choices
because teher are two type of herniation on that part of the brain,supra or infratentorium
subfacial or a transtentorial hernia
transtentorial herniation,especially the caudal type is life threatening it compress brain stem and damage vital regulatory centers for repiration,conscioness,blood pressure
so if you could give me more about the question so I can help you out
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| waqastariq
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well just a correction 'smal' it is not tranforaminal but transtentorial herniation nadiabarati is talking about...excuse me if I am being rude here
about transtentorial...better say that it is usually UNCAL HERNIATION...
the components of interpeduncular fossa are damaged..
the cerebral peduncle of one side (crus cerebri) is compressed explaining the contralateral hemipresis as the fibers have not yet crossed...
Kernohan notch is formed...damaging corticospinal, corticobulbar and corticopontine fibers...
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| waqastariq
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okay so there is contralateral hemiperesis...
now talkin about occulomotor effects so the parasympathetic fibers that are running on the outside of occulomotor nerve are also compressed...leading to dysfunction and hence there is pupillary dilatation due to unopposed action on the ciliary muscles 
finally....the posterior cerebral artery is also compressed causing contralateral hemianopia as the visual cortex is affected...
I hope it is clear now thanks
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| waqastariq
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contralateral hemiperesis, contralateral hemianopia and ipsilateral pupillary dilatation occur in uncal/transtentorial herniation
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| Dr.Papez
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Waq has explained nicely.
It can be otherway also if the lesion producing pressure is away from the midbrain region. The whole brain stem may be shifted to opposite side and compres over the tentorium on the oppsite side and affect opp crus cerebri, opp 3rd nerve and opp PCA. This variety is less common but can be confusing
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| vanshita
Forum Guru
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waq nice explation
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| spork
Forum Newbie
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In regards to the uncal herniation I am not clear on the type of visual field defect caused. My version of FA says that it causes contralateral homonymous hemianopsia -- is this a loss of the lateral visual field vision of the eye opposite eye? Or does it mean that both eyes are affected? I don't recall anything previously mentioning full loss of lateral hemianopic vision contralaterally -- what would the neural deficit be that would lead to this. Thx.
Edited by spork on 06/09/06 - 06:12 PM
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| docarchana
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ipsilateral CNIII palsy, contralateral homonymous hemianopia, contralateral hemiparesis..
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