{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:10:16Z","timestamp":1779527416095,"version":"3.53.1"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:p>The authors describe the case of a boy with Muenke syndrome, an autosomal dominant disorder associated with craniosynostosis. The family history was significant for syndromic craniosynostosis in the patient\u2019s maternal grandmother, who died in adulthood after a craniofacial reconstruction. The patient, her grandson, underwent craniofacial reconstruction surgery at the age of 9 months and developed upward transtentorial herniation. Imaging findings revealed remote cerebellar hemorrhage after a large quantity of supratentorial CSF was drained during postoperative Day 1. The clinical course was further complicated by cerebral sinus thrombosis, which was diagnosed after a fourth surgical procedure. Upward transtentorial herniation can occur when a significant increase in intracranial pressure in the posterior fossa causes displacement of the central lobule and superior surfaces of the cerebellum upward through the incisura tentorii. This is a rare but well-documented phenomenon that commonly occurs in the setting of an expansive posterior fossa lesion or excessive supratentorial CSF loss. To help clinicians recognize and prevent this rare but potentially fatal complication, the authors review the postulated mechanisms by which this process may occur.<\/jats:p>","DOI":"10.3171\/2015.2.focus151","type":"journal-article","created":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T03:36:59Z","timestamp":1430451419000},"page":"E8","source":"Crossref","is-referenced-by-count":1,"title":["Upward transtentorial herniation following frontoorbital advancement for syndromic craniosynostosis: case report"],"prefix":"10.3171","volume":"38","author":[{"given":"Vivek","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, USC Keck School of Medicine, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bakhsheshian","sequence":"additional","affiliation":[{"name":"Chicago Medical School at Rosalind Franklin University of Medicine & Science, North Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir H.","family":"Dorafshar","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward S.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus151","series-title":"GeneReviews","article-title":"Muenke Syndrome","author":"Agochukwu","year":"2014"},{"key":"b2-focus151","series-title":"J Oral Maxillofac Surg","first-page":"2522","article-title":"Prevalence and impact of complications on hospitalization outcomes following surgical repair for craniosynostosis","volume":"72","author":"Allareddy","year":"2014"},{"key":"b3-focus151","series-title":"AJNR Am J Neuroradiol","first-page":"387","article-title":"Remote cerebellar hemorrhage","volume":"27","author":"Amini","year":"2006"},{"key":"b4-focus151","series-title":"Cerebellum","first-page":"64","article-title":"Remote cerebellar hemorrhage: a review","volume":"5","author":"Brockmann","year":"2006"},{"key":"b5-focus151","series-title":"J Neurosurg","first-page":"1159","article-title":"Zebra sign: cerebellar bleeding pattern characteristic of cerebrospinal fluid loss. 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