Abstract
Idiopathic brain herniation caused by a focal dural defect can be confused for a mass or post-traumatic herniation. The prevalence of idiopathic brain herniation has never been described. We sought to ascertain the prevalence of idiopathic cuneate gyrus herniation in a general emergency room (ER) population on computed tomography (CT) imaging. The purpose of this study is to elucidate cuneate gyrus herniation and differentiate it from other pathologic conditions such as mass or traumatic herniation and to provide its anatomical prevalence in an ER population. Consecutive emergency room CT scans of the brain were evaluated prospectively for cuneate gyrus herniation over a 1 year period by a neuroradiologist. Of 1,500 brain CT scans evaluated, 11 patients demonstrated idiopathic cuneus gyrus herniation. The prevalence was 0.73 %. CT manifestations are normal brain tissue herniating into the superior cerebellar cistern. Idiopathic brain herniation can be mistaken for a pathologic process. We found the prevalence of one such idiopathic brain herniation, involving the cuneus gyrus, to be exceedingly rare. CT imaging demonstrates normal brain tissue herniating beyond the dural boundary.
Similar content being viewed by others
References
Sodickson A, Okanobo H, Ledbetter S (2011) Spiral head CT in the evaluation of acute intracranial pathology: a pictorial essay. Emerg Radiol 18:81–91
Zacharia TT, Nguyen DT (2010) Subtle pathology detection with multidetector row coronal and sagittal CT reformations in acute head trauma. Emerg Radiol 17:97–102
Horowitz M, Kassam A, Levy E, Lunsford LD (2002) Misinterpretation of parahippocampal herniation for a posterior fossa tumor: imaging and intraoperative findings. J Neuroimaging 12(1):78–79
Duarte MP, Maldjian TC, Tenner M, Adam R (2007) Magnetic resonance imaging of idiopathic herniation of cuneus gyrus. J Neuroimaging 17(4):353–354
Larsen WJ (1997) Human embryology, 2nd edn. Churchill Livingstone, New York, pp 435–437; NLM ID:9705346 [Book]
O’Rahilly R, Muller F (1986) The meninges in human development. J Neuropathol Exp Neurol 45(5):588–608
Naidich TP, McLone DG, Fulling KH (1983) The Chiari II malformation: Part IV. The hindbrain deformity. Neuroradiology 25(4):179–197
Acknowledgement
The data for this investigation was obtained from Bronx Lebanon Hospital Center.
Ethical standards
This study complies with the current laws of the country in which it was performed.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Maldjian, C., Adam, R. Prevalence of idiopathic cuneate gyrus herniation based on emergency room CT examinations. Emerg Radiol 21, 387–389 (2014). https://doi.org/10.1007/s10140-014-1212-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-014-1212-6