Midline shift is a shift of the brain past its center line.[1] The sign may be evident on neuroimaging such as CT scanning.[1] The sign is considered ominous because it is commonly associated with a distortion of the brain stem that can cause serious dysfunction evidenced by abnormal posturing and failure of the pupils to constrict in response to light.[1] Midline shift is often associated with high intracranial pressure (ICP), which can be deadly.[1] In fact, midline shift is a measure of ICP; presence of the former is an indication of the latter.[2] Presence of midline shift is an indication for neurosurgeons to take measures to monitor and control ICP.[1] Immediate surgery may be indicated when there is a midline shift of over 5 mm.[3][4] The sign can be caused by conditions including traumatic brain injury,[1] stroke, hematoma, or birth deformity that leads to a raised intracranial pressure.
- ^ a b c d e f Gruen P (May 2002). "Surgical management of head trauma". Neuroimaging Clinics of North America. 12 (2): 339–43. doi:10.1016/S1052-5149(02)00013-8. PMID 12391640.
- ^ Maas AI, Stocchetti N, Bullock R (August 2008). "Moderate and severe traumatic brain injury in adults". Lancet Neurology. 7 (8): 728–41. doi:10.1016/S1474-4422(08)70164-9. PMID 18635021. S2CID 14071224.
- ^ Cite error: The named reference
Tu2was invoked but never defined (see the help page). - ^ Valadka AB (2004). "Injury to the cranium". In Moore EJ, Feliciano DV, Mattox KL (eds.). Trauma. New York: McGraw-Hill, Medical Pub. Division. p. 389. ISBN 0-07-137069-2. Retrieved 2008-08-15.