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Brain herniations predominantly result from increased intracranial pressures due to various etiologies and are usually acute. Chronic medial temporal lobe [uncal and parahippocampal] herniation has been rarely reported in literature. Unilateral and bilateral idiopathic temporal lobe [uncal and parahippocampal] herniations have been even more rarely reported. It’s important to diagnose idiopathic temporal lobe herniations, as these are “do not touch” lesions. In this paper we presented two cases with nonemergent medial temporal lobe herniations. Standard MRI of the brain was performed in a 3T Siemens magnet with a standard head coil, to make the diagnosis. First patient is a 40 year-old female with a longstanding history of headaches and bilateral idiopathic uncal herniations. Second patient is a 21-year old female with shunt revisions for hydrocephalus since a young age. She had unilateral right uncal and parahippocampal herniation, and an ipsilateral dural based right frontal calcified small mass without significant mass effect on the nearby structures.

journal of medical imaging and case reports

Nonemergent Descending Transtentorial Temporal Lobe Herniations – Case Reports of Idiopathic [Bilateral Uncal] and Chronic [Unilateral Uncal and Parahippocampal] Herniations with Review of Literature