Systematic Review: Identifying The Most Common Type And The Mostly Shown Clinical Manifestations Of Brain Herniation In Traumatic Brain Injury

  • Nikita
  • Rohadi Neurosurgeon in NTB General Hospital
  • Bambang
  • Dyah
  • arya
  • Mervin
  • Zikrul
  • Taufik
  • tomi
  • Fauzan
  • Evan RSUD Praya
  • Widiyanto
  • Sanditias Putrawan
  • Shaktisila


  Background: Brain herniation occurs when there is something in the brain that pushes brain tissue. Brain herniation is a mechanical dislocation of brain organs to other regions due to mass, trauma, neoplastic, ischemic or infection. Because the herniation itself causes high pressure on certain brain structures, it is fatal. Hence at all hospitals, the first action performed is nothing but reducing intracranial pressure.On neurological examination, there is a decrease in the degree of consciousness. Depending on the severity of the herniation, interference with one or more brainstem reflexes as well as the function of the cranial nerve may occur. Patients will also show a consistent inability to breathe and irregular heartbeats..   Methods: Using established systematic review methods, three databases  (PubMed, Cochrane, ScienceDirect) with publication time before June 2021. We only include English literature in this review. Inclusion criteria was the study that published at the last 10 years, and only take a study that discuss about brain herniation in traumatic brain injury, the exclusion criteria that this review didn’t take an article journal as areference.   Results and conclusion: Ten studies (more than 1000 patients) were included.The current researches about the most common type and the most shown clinical manifestation of brain herniation in traumatic brain injury have been studied for the past few years, the result shows that most common type of the brain herniation is supratentorial herniation (transcalvaria/ekstracranial herniation (40%), transtentorial/central herniation (30%), uncal herniation (30%)). While The most common clinical manisfestation of brain herniation in traumatic brain injury based on this research are dilated pupil and decreased of consciousness.   Keywords: Most common type, Clinical Manifestation, Brain Herniation, Traumatic Brain Injury, Systematic review.