The tentorial notch (also known as the tentorial incisure or incisura tentorii) refers to the anterior opening between the free edge of the cerebellar tentorium and the clivus for the passage of the

brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is conti ...

. The

midbrain The midbrain or mesencephalon is the uppermost portion of the brainstem connecting the diencephalon and cerebrum with the pons. It consists of the cerebral peduncles, tegmentum, and tectum. It is functionally associated with vision, hearing, mo ...

continues with the

thalamus The thalamus (: thalami; from Greek language, Greek Wikt:θάλαμος, θάλαμος, "chamber") is a large mass of gray matter on the lateral wall of the third ventricle forming the wikt:dorsal, dorsal part of the diencephalon (a division of ...

of the

diencephalon In the human brain, the diencephalon (or interbrain) is a division of the forebrain (embryonic ''prosencephalon''). It is situated between the telencephalon and the midbrain (embryonic ''mesencephalon''). The diencephalon has also been known as t ...

through the tentorial notch.

Structure

The tentorial notch is located between the tentorial edges and communicates the supratentorial and infratentorial spaces. This area can be divided into three spaces: ''anterior'', ''middle'' (lateral to), and ''posterior'' to the brainstem. The middle incisural space is close to the

and the upper

pons The pons (from Latin , "bridge") is part of the brainstem that in humans and other mammals, lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum. The pons is also called the pons Varolii ("bridge of ...

at the level of the pontomesencephalic sulcus. Medial temporal lobe structures such as the uncus, the parahippocampal gyrus and the hippocampal formation, are also intimately related to the incisura. The principal vascular structures coursing along the middle incisural space are the

posterior cerebral artery The posterior cerebral artery (PCA) is one of a pair of cerebral arteries that supply oxygenated blood to the occipital lobe, as well as the medial and inferior aspects of the temporal lobe of the human brain. The two arteries originate from the d ...

and the

superior cerebellar artery The superior cerebellar artery (SCA) is an artery of the head. It arises near the end of the basilar artery. It is a branch of the basilar artery. It supplies parts of the cerebellum, the midbrain, and other nearby structures. It is the cause of t ...

which pass around the brainstem, parallel to the free tentorial edge. The incisura has also a close relationship with the first 6 cranial nerves.Rothon Jr AL. Tentorial incisura. Neurosurgery 2000;47(Suppl. 3):131–53.

Clinical significance

intracranial pressure Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury ( mmHg) and at rest, is normally 7–15 mmHg for a supine adu ...

superior to the cerebellar tentorium is increased, it may force part of the

temporal lobe The temporal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The temporal lobe is located beneath the lateral fissure on both cerebral hemispheres of the mammalian brain. The temporal lobe is involved in pr ...

through this notch. This is referred to as a tentorial

brain herniation Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the human brain, brain is squeezed across structures within the human skull, skull. The brain can shift across such structures ...

. The consequences are unconsciousness, widening of the pupil of the affected side, and

hemiparesis Hemiparesis, also called unilateral paresis, is the weakness of one entire side of the body (''wikt:hemi-#Prefix, hemi-'' means "half"). Hemiplegia, in its most severe form, is the complete paralysis of one entire side of the body. Either hemipar ...

on the opposite side.

References

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