Midline shift is when the brain moves beyond the centerline due to a traumatic event, indicating further problems such as intracranial pressure or tumor growth. Symptoms include leaning to one side, impaired vision, and abnormal behavior. Treatment may involve specialized glasses or surgery. Intracranial pressure often accompanies midline shift.
Midline shift refers to when a person’s brain actually moves beyond the centerline of the brain. The displacement is usually caused by a traumatic event involving the brain or head and can indicate further problems with the brain, such as intracranial pressure or tumor growth. The brain normally drifts away from a traumatized section, causing neurological abnormalities that affect patient behavior.
Causes of midline shift usually involve a violent event that negatively impacted a person’s brain. A severe head injury, such as an automobile accident or a serious collision in a contact sport, can cause a brain shift. Other traumatic events that can affect the positioning of the brain include a stroke, brain swelling, or the development of a brain tumor.
People who have experienced a midline shift show some specific signs of the condition. A person might lean to the side of the body that corresponds to the direction the brain has moved and have trouble walking straight or bumping into obstacles. The patient’s vision may also be impaired, causing problems with perceiving spatial relationships and performing simple motor tasks such as playing cards. If a person is suffering from a change, shining a light on their eyes does not cause the pupils to constrict as they normally would.
Treatment of midline shift might involve the patient using specialized eye glasses. These glasses contain yoked prisms that influence the patient’s visual perception, compensating for changes in the person’s vision. By wearing glasses, a person suffering from this condition can once again balance himself and function normally. An optometrist may need to change the glasses later as the person’s condition changes, allowing them to continue operating without problems.
A neurosurgeon might decide to operate on a patient if the midline shift constitutes a movement of about a fifth of an inch (five millimeters) or more. Such a dramatic brain change constitutes a medical emergency as it threatens the patient’s life. The surgeon might remove any growth, benign or malignant, that is causing the displacement, or even remove part of the patient’s skull if the brain swells, preventing permanent brain damage.
Intracranial pressure (ICP) often goes hand in hand with midline shift. Causes of ICP include brain tumors, brain swelling, or heart failure. Signs that a person has ICP might include unexplained vomiting, blurring at the edges of a person’s field of vision, and persistent back pain.
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