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February 1992

Traumatic Transtentorial Herniation and Its Management

Author Affiliations

Syracuse, NY

Arch Neurol. 1992;49(2):127. doi:10.1001/archneur.1992.00530260025007

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This compact book is derived from and, in a straightforward way, summarizes the practice plan of two well-qualified authors with vast experience in the care of patients with severe head injuries. The focus on transtentorial herniation and brain-stem compromise heightens the issue in a particularly significant manner. The core issue in these patients is certainly the management of those with this clear warning signal that the circumstance is not necessarily irreversible and unmanageable. Immediate and vigorous care may well be consequential. It is refreshing to see Andrews and Pitts' emphasis on criteria for immediate definitive intervention in well-defined circumstances based on early indicators of brain-stem compression. Their review of the anatomy, early clinical evaluation, and management of these patients is well presented. The

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