{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T21:00:46Z","timestamp":1784062846492,"version":"3.55.0"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1989,10]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Recently, Ropper reported that horizontal brain shift caused by acute unilateral mass lesions correlated closely with consciousness, and suggested that recovery of consciousness was unlikely to occur after surgical evacuation if the shift was insufficient to explain the observed diminution of consciousness. The authors have sought to confirm the correlation of pineal shift with level of consciousness and to assess the prognostic value of brain shift measurements in a prospective study. Forty-six patients (19 with subdural hematoma, 14 with intracerebral hematoma, and 13 with epidural hematoma) were accrued to the study group consecutively. A correlation was found between a decrease in the level of consciousness and a significant increase in the mean lateral brain displacement at the pineal gland (from 3.8 to 7.0 mm) and septum (5.4 to 12.2 mm). When outcome was examined in patients who were stuporous or comatose on admission, a significant increase in septal shift was found among patients with a poor outcome, but there was no significant relationship between outcome and degree of pineal or aqueductal shift. A poor outcome was more likely with effacement of both perimesencephalic cisterns or the ipsilateral cistern, but not the contralateral cistern, although this difference did not reach statistical significance. These results do not substantiate the value of brain shift as an independent prognostic factor after evacuation of an acute unilateral mass lesion. The decision to operate and the determination of prognosis should be based rather on established criteria such as the clinical examination, age of the patient, and the mechanism of injury.<\/jats:p>","DOI":"10.3171\/jns.1989.71.4.0498","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:23:22Z","timestamp":1241799802000},"page":"498-502","source":"Crossref","is-referenced-by-count":65,"title":["Brain shift, level of consciousness, and restoration of consciousness in patients with acute intracranial hematoma"],"prefix":"10.3171","volume":"71","author":[{"given":"Donald A.","family":"Ross","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter L.","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M.","family":"Ross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence H.","family":"Pitts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"518","DOI":"10.3171\/jns.1988.69.4.0518","article-title":"The effect of intracerebral hematoma location on the risk of brain-stem compression and on clinical outcome.","volume":"69","author":"Andrews","year":"1988"},{"key":"b2","series-title":"Neurosurgery","first-page":"237","article-title":"Outcome in 200 consecutive cases of severe head injury treated in San Diego County: a prospective analysis.","volume":"6","author":"Bowers","year":"1980"},{"key":"b3","series-title":"Acta Neurochir Suppl","first-page":"112","article-title":"Prognosis and prediction of outcome in comatose head injured patients.","volume":"36","author":"Braakman","year":"1986"},{"key":"b4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3171\/jns.1982.56.1.0026","article-title":"Influence of the type of intracranial lesion on outcome from severe head injury.","volume":"56","author":"Gennarelli","year":"1982"},{"key":"b5","series-title":"Clin Neurosurg","first-page":"346","article-title":"Prognosis in head injury.","volume":"19","author":"Jane","year":"1982"},{"key":"b6","series-title":"Neurosurgery","first-page":"283","article-title":"Prognosis of patients with severe head injury.","volume":"4","author":"Jennett","year":"1977"},{"key":"b7","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1212\/WNL.35.8.1122","article-title":"Auditory evoked potentials in coma after closed head injury: a clinical-neurophysiological coma scale for predicting outcome.","volume":"35","author":"Karnaze","year":"1985"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3171\/jns.1983.59.2.0285","article-title":"The National Traumatic Coma Data Bank. Part 2: Patients who talk and deteriorate: implications for treatment.","volume":"59","author":"Marshall","year":"1983"},{"key":"b9","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1136\/jnnp.50.4.389","article-title":"Outcome prediction in comatose patients: significance of reflex eye movement analysis.","volume":"50","author":"Mueller-Jensen","year":"1987"},{"key":"b10","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1056\/NEJM198604103141504","article-title":"Lateral displacement of the brain and level of consciousness in patients with an acute hemispheral mass.","volume":"314","author":"Ropper","year":"1986"},{"key":"b11","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1227\/00006123-198103000-00001","article-title":"Calculated recovery rates in severe head injury.","volume":"8","author":"Salcman","year":"1981"},{"key":"b12","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1097\/00005373-198609000-00003","article-title":"Traumatic intracerebral hematomas: timing of appearance and indications for operative removal.","volume":"26","author":"Soloniuk","year":"1986"},{"key":"b13","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"691","DOI":"10.3171\/jns.1984.61.4.0691","article-title":"Absent or compressed basal cisterns on first CT scan: ominous predictors of outcome in severe head injury.","volume":"61","author":"Toutant","year":"1984"},{"key":"b14","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1227\/00006123-198703000-00007","article-title":"Influence of lesions detected by computed tomography on outcome and neuropsychological recovery after severe head injury.","volume":"20","author":"Uzzel","year":"1987"},{"key":"b15","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1227\/00006123-198704000-00011","article-title":"Magnetic resonance imaging in cases of severe head injury.","volume":"20","author":"Wilberger","year":"1987"},{"key":"b16","series-title":"J Neurosurg","first-page":"196","article-title":"Neurosurgical Classic XXIX. Naffziger HC: A method for the localization of brain tumors \u2014 the pineal shift.","volume":"22","author":"Wilkins","year":"1965"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/71\/4\/article-p498.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/71\/4\/article-p498.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/71\/4\/article-p498.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T21:31:09Z","timestamp":1679866269000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/71\/4\/article-p498.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,10]]},"references-count":16,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/jns.1989.71.4.0498","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1989,10]]}}}