The brain is an organ of immense complexity. In the cranium, dural reflections and bony landmarks divide the brain into anatomic regions. Brain herniation represents mechanical displacement of normal brain relative to another anatomic region secondary to mass effect from traumatic, neoplastic, ischemic, or infectious etiologies. Brain herniation is classified as intracranial or extracranial. An intracranial hernia can be subfalcine, transtentorial (ascending or descending), or tonsillar. Brain herniation can result in brain damage, compression of cranial nerves and vessels (causing hemorrhage or ischemia), or obstruction of the normal CSF circulation, producing hydrocephalus.  CT is the preferred imaging modality for brain herniation because of the short acquisition time, the cost, and the wide availability. Prompt diagnsosis is essential because patients with brain herniation are generally in critical condition.

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