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Brain swelling, increased pressure can cause deadly brain herniation

People who've had recent head trauma or brain surgery have a higher risk

There’s only so much room in your skull. If something takes up too much space within the skull, it can cause a potentially-deadly brain herniation.

Brain herniation is the movement of brain tissue from an area of high pressure (within the skull) to an area where there’s less pressure (eventually down through the foramen magnum, the hole in the back bottom of the skull where the brain connects to the spinal cord).

When the brain itself herniates, it creates new pressure that cuts off blood flow to the essential structures and can lead to death.

What can cause brain herniation?

There are myriad conditions that can lead to brain herniation. In one of the first brain herniation cases that I handled, Painter Law Firm hired a renowned medical internal medicine expert who coined the term to describe all of them—space-occupying lesions.

Space-occupying lesions are anything that takes up extra space inside the cranial cavity. In the Houston medical malpractice lawsuit that I just referenced, the patient developed hyponatremia, or low sodium levels in the blood.

A few weeks before the hospitalization, the patient had a sinus infection that ended up spreading to the frontal lobe of her brain. She had nausea, vomiting, and a terrible headache. At first, a suburban hospital thought an MRI showed a brain tumor, so they sent her to a hospital in the Texas Medical Center. There, the neurosurgery team figured out that an infectious abscess had formed and needed to be drained. After that short procedure, the patient was doing great. In the following days, though, the nurses didn’t pay attention to her routine lab work that showed her sodium was out of whack.

When that little element of sodium gets too low, it causes massive brain swelling. If it isn’t promptly and carefully corrected, the brain can herniate. Although this young patient had the classic signs and symptoms of hyponatremia, the nurses and doctors didn’t recognize it until it was too late. Her brain herniated, causing massive permanent brain damage.

Other potential causes of brain herniation include things like a tumor, infection, edema (swelling), hematoma, brain bleeding, or any type of head trauma. Physicians need to be on the lookout for anything that increases intracranial pressure (ICP) because it could pose a potential danger of brain herniation.

What are the signs of impending brain herniation?

One of the earliest indicators that something may be wrong is a change in behavior, which healthcare providers describe as altered mental status. Quite often, family members or friends will be the first to notice this.

Other frequent signs and symptoms of impending brain herniation include:

• An altered level of consciousness

• Nausea and vomiting

• Abnormal posturing

How’s it avoided or treated?

The goal of treating brain herniation is addressing and correcting whatever condition is causing the increased intracranial pressure before the brain herniates.

This means that nurses and doctors need to be attentive to patients, particularly to those with a known risk of high intracranial pressure because of a recent head trauma or brain surgery.

Depending on when the problem is identified, there can be interventions ranging from administrating an anti-swelling medication, such as mannitol, to removing part of the skull surgically to allow the brain to decompress.

If you or a loved one has been seriously injured because of poor surgical, neurosurgical, or hospital care, then contact a top-rated experienced Houston, Texas medical malpractice lawyer for help in evaluating your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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