Cerebral edema, with herniation of the cerebellar tonsils
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Edema of the brain, whether due to infarct, tumor, or infection, may cause herniation of the brain. It can herniate across the falx, into the tentorium (uncal herniation), or into the foramen magnum (shown here). The brain may also herniate through any opening in the skull, produced by trauma or by a surgeon. Note the grooves surrounding the spinal cord. The cerebellum is pressed against the medulla, resulting in ischemia and destruction of the centers responsible for respiration.