Brain intussusception is the abnormal displacement of nerve tissue within the skull. Depending on which parts of the brain move and into what areas, there are several types of brain invagination. Regardless of the division, intussusception has one common denominator: these conditions are extremely dangerous, because they can quickly lead to the death of the patient.
Brain intussusceptionis otherwisebrain wedging . The term intussusception is defined as the pathological displacement of a tissue into an abnormal, unusual place for it. Intussusception is treated as dangerous conditions - they can lead to various serious complications. For example, the blood supply to the invaginated part of an organ may be blocked, leading to ischemia and eventually necrosis.
Most - due to the frequency of this phenomenon - is intussusception. However, intussusception can also occur in organs that are not part of the digestive system, such as intussusception in the brain. It is a very serious condition that can even lead to death. The prognosis for patients with cerebral intussusception is poor.
Brain intussusception: causes
Increased intracranial pressure causes the invagination of the brain, i.e. the displacement of nervous tissue fragments. In a situation where the pressure inside the skull is increased, individual parts of the brain may be dislocated. It also happens that the intussusception occurs when the intracranial pressure is normal, e.g. when there is a formation in some part of the skull that compresses the nerve tissue and leads to its displacement (we are talking here about various pathological changes that exert the so-called mass effect).
The following pathologies can be mentioned as causes of brain invagination:
- tumors of the central nervous system compressing the nervous tissue
- intracranial hematomas
- having a serious head injury
- infectious processes (e.g. brain abscess)
- brain swelling
- stroke
- intracranial bleeding
Brain intussusception: types
Due to which parts of the brain are invaginated and to which structures they move, there are several types of brain invaginations.Individual parts of the brain can move in relation to the dural extensions, which are the crescent of the brain and the cerebellar tent. In addition, the nervous tissue may shift towards the foramen of the skull (this is the opening through which the medulla, numerous nerves and blood vessels pass).
In connection with the above, there are mentioned, among others, the following types of brain dimples:
- central intussusception (in which the brain stem is displaced into the great foramen)
- lateral intussusception (where the medial part of the temporal lobe of the brain is invaginated between the indentation of the cerebellar tent and the midbrain)
- intussusception of the cerebellar tonsils (in which these structures move to the great foramen of the skull)
- invagination of the cingulate gyrus (where this structure, which is part of the limbic system, is invaginated between the lower part of the sickle of the brain and the upper part of the corpus callosum)
Brain intussusception: symptoms
The symptoms of intussusception depend on what type of intussusception the patient has. For example, a cingulate gyrus invagination can be completely asymptomatic and can only be determined on the basis of characteristic abnormalities in the imaging examinations. In other types of brain intussusception, patients may develop serious symptoms such as:
- vomiting
- pupil dilation and no reaction to light
- disturbance of consciousness
- neck stiffness
- symptoms of paralysis of individual cranial nerves
- slow heart rate
- paralysis (one-sided or two-sided)
- slow breathing rate
Particularly dangerous are those types of brain cavities in which there is a displacement and compression of structures belonging to the brainstem. Patients with such problems may fall into a coma, and in addition - due to damage to the respiratory center - they may experience respiratory arrest, cardiac arrest and eventually death.
Brain intussusception: diagnosis
The diagnosis of brain intussusception is made on the basis of imaging tests, such as computed tomography or magnetic resonance imaging of the head. Thanks to this, it is possible to visualize not only the fact that the elements of the brain have been pathologically dislocated. It is also not uncommon to illustrate the pathology that led to this state.
Brain Intussusception: Treatment
In patients who develop intussusception, first of all the causes of this problem should be removed. If the presence of a cancerous tumor has led to the movement of nerve tissue, it existsthe need to resect this lesion. When the cause of the brain intussusception is an intracranial hematoma, the patient is evacuated from the skull.
Treatment of brain intussusception is based primarily on surgical procedures and typically involves performing a craniectomy on patients. Non-surgical interactions, aimed at lowering intracranial pressure, are also important (if, of course, the patient experiences an increase in this parameter). For this purpose, for example, osmotic agents (such as mannitol) and diuretics can be used.
1. Neurology, scientific eds. Wojciech Kozubski, Paweł P. Liberski, publ. PZWL, Warsaw 20142. Andrea Halliday, Cerebral Herniation Syndromes, on-line access: https://www.peacehe alth.org/sites/default/files/Documents/Neuro%202012%20Halliday%20Presentation.pdf3. Stephan A. Mayer et al., Cerebral Edema, Intracranial Pressure, and Herniation Syndromes, Journal of Stroke and Cerebrovascular Diseases, Vol. 8, No. 3 (May-June), 1999: pp 183-191; on-line access: http://www.strarówkaournal.org/article/S1052-3057(99)80025-1/pdf
About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.