Midline shift
Sideways displacement of the brain / From Wikipedia, the free encyclopedia
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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.