Midline shift is a finding where structures in the brain that normally sit in the middle are pushed to one side, usually because of swelling, bleeding, or a mass.
Possible symptoms include severe headache, vomiting, drowsiness, confusion, weakness on one side, slurred speech, or reduced consciousness.
Imaging shows how much the midline has shifted, what is causing it, and whether the brain is herniating into nearby spaces — all critical for surgical planning.
CT of the head is the fastest first test; MRI may follow for more detailed assessment when the picture is clearer.
Treatment may include steroids, mannitol, or hypertonic saline to reduce brain swelling, surgical evacuation of a bleed, or removal of a mass — depending on the cause.
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