Midline shift
Updates to Article Attributes
One of the most important indicators of increased intracranial pressure due to mass effect is midline shift. Any intra-axial or extra-axial lesion (tumour, haemorrhage, abscess, etc) has the potential to exert mass effect on the brain parenchyma and cause lateral shift of the midline structures.
It is measured in millimeters, as the perpendicular distance between a midline structure (usually the septum pellucidum) and a line designated the midline. The midline is assumed to be a plane coplanar with falx cerebri, and is best represented as a line drawn between the anterior and posterior attachments of the falx. Care must be taken if there is existing asymmetry of the ventricles or the falx. If the falx is straight, a line between the free edge of the anterior and posterior falx can be used instead.
The amount of midline shift is one of the strongest indicators of neurosurgical prognosis and can be associated with other sings of increased intracranial pressure such as:
- effacement
- asymmetry of the basal cisterns
- hydrocephalus
-
herniation
- subfalcine
- transtentorial
- tonsillar
- external
-<p>One of the most important indicators of increased intracranial pressure due to mass effect is <strong>midline shift</strong>. Any intra-axial or extra-axial lesion (tumour, haemorrhage, abscess, etc) has the potential to exert mass effect on the brain parenchyma and cause lateral shift of the midline structures.</p><p>It is measured in millimeters, as the perpendicular distance between a midline structure (usually the <a title="septum pellucidum" href="/articles/septum-pellucidum">septum pellucidum</a>) and a line designated the midline. The midline is assumed to be a plane coplanar with <a href="/articles/falx-cerebri">falx cerebri</a>, and is best represented as a line drawn between the anterior and posterior attachments of the falx. Care must be taken if there is existing asymmetry of the ventricles or the falx. If the falx is straight, a line between the free edge of the anterior and posterior falx can be used instead.</p><p>The amount of midline shift is one of the strongest indicators of neurosurgical prognosis and can be associated with other sings of increased intracranial pressure such as:</p><ul>- +<p>One of the most important indicators of increased intracranial pressure due to mass effect is <strong>midline shift</strong>. Any intra-axial or extra-axial lesion (tumour, haemorrhage, abscess, etc) has the potential to exert mass effect on the brain parenchyma and cause lateral shift of the midline structures.</p><p>It is measured in millimeters, as the perpendicular distance between a midline structure (usually the <a href="/articles/septum-pellucidum">septum pellucidum</a>) and a line designated the midline. The midline is assumed to be a plane coplanar with <a href="/articles/falx-cerebri">falx cerebri</a>, and is best represented as a line drawn between the anterior and posterior attachments of the falx. Care must be taken if there is existing asymmetry of the ventricles or the falx. If the falx is straight, a line between the free edge of the anterior and posterior falx can be used instead.</p><p>The amount of midline shift is one of the strongest indicators of neurosurgical prognosis and can be associated with other sings of increased intracranial pressure such as:</p><ul>
-<li><a title="sulcal effacement" href="/articles/sulcal-effacement">sulcal</a></li>-<li><a title="ventricular effacement" href="/articles/ventricular-effacement">ventricular</a></li>- +<li><a href="/articles/sulcal-effacement">sulcal</a></li>
- +<li><a href="/articles/ventricular-effacement">ventricular</a></li>
-<li><a title="Communicating hydrocephalus" href="/articles/obstructive-hydrocephalus">hydrocephalus</a></li>- +<li><a href="/articles/obstructive-hydrocephalus">hydrocephalus</a></li>
-<a title="Brain herniation" href="/articles/cerebral-herniation">herniation</a><ul>-<li><a title="Subfalcine herniation" href="/articles/subfalcine-herniation">subfalcine</a></li>-<li><a title="Transtentorial herniation" href="/articles/transtentorial-herniation">transtentorial</a></li>- +<a href="/articles/cerebral-herniation">herniation</a><ul>
- +<li><a href="/articles/subfalcine-herniation">subfalcine</a></li>
- +<li><a href="/articles/transtentorial-herniation">transtentorial</a></li>
-<li><a title="external herniation" href="/articles/external-herniation">external</a></li>- +<li><a title="Extracranial brain herniation" href="/articles/extracranial-brain-herniation">external</a></li>
Tags changed:
- herniation
Sections changed:
- Gamuts
Systems changed:
- Central Nervous System
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