A practical radiology review of Cerebral Herniation: Imaging Essentials, focused on imaging findings, differential diagnosis, reporting points, and high-yield teaching pearls.
A practical radiology review of Cerebral Herniation: Imaging Essentials, focused on imaging findings, differential diagnosis, reporting points, and high-yield teaching pearls.
Record midline shift in millimeters as displacement of the septum pellucidum from the expected midline and state the measurement level. The number alone does not define clinical severity. Add subfalcine passage of the cingulate gyrus, lateral ventricular compression, contralateral ventricular enlargement, and sulcal effacement to the same assessment.
Review the suprasellar, ambient, and quadrigeminal cisterns separately. Replace a vague statement such as "basal cisterns are effaced" with the specific cistern involved and any brainstem deformation. Example impression: Right hemispheric mass effect produces 8 mm leftward midline shift, compression of the right lateral ventricle, and subfalcine herniation. The right ambient cistern is effaced and the midbrain is displaced leftward, supporting associated right uncal herniation.
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