Submigration of cerebellar tonsils should be alerted to the occurrence of cerebellar tonsillar hernia, which should be promptly treated with cranial pressure reduction and as soon as possible surgical removal of the cause or palliative treatment.
Cerebellar tonsil herniation is the herniation of the cerebellar tonsils and medulla oblongata through the foramen magnum of the occipital bone to be pushed into the vertebral canal under intracranial pressure, which may lead to damage to the vital center and the risk of sudden respiratory arrest and death.
If the cerebellar tonsils are found to be displaced, possible etiologies such as intracranial hematoma, massive cerebral infarction, intracranial tumors, etc. should be urgently investigated, and the patient’s vital signs, mental state, and pupil changes should be closely monitored, and drugs such as hydrochlorothiazide and acetazolamide should be administered orally to reduce cranial pressure as appropriate, or a rapid drip of 20% mannitol for dehydration to reduce cranial pressure should be administered.
If the cause of the disease is clear and the patient’s condition permits, surgery can be performed as soon as possible to remove the cause of the disease, such as removing intracranial hematoma, removing brain tumors. If it is difficult to confirm the diagnosis or the cause cannot be removed in time, palliative surgery can be used to reduce intracranial hypertension, such as lateral ventricular external drainage, cerebrospinal fluid shunt, debridement and decompression.