Which type of shift in intracranial content is common in children with progressive hydrocephalus

Hydrocephalus is a condition in which the primary characteristic is excessive accumulation of cerebrospinal fluid (CSF) the clear fluid that surrounds the brain and spinal cord. This excessive accumulation results in an abnormal dilation of the spaces in the brain called ventricles. Increased pressure in the posterior fossa forces the cerebellar tonsils through the foramen magnum. These will compress the lower pa of the brain stem and upper cervical cord, resulting in life-threatening consequences. It usually occurs along with ascending or descending transtentorial herniation. (1) CINGULATE (SUBFALCINE) HERNIATION under falx cerebri. (2) CENTRAL (DOWNWARD TRANSTENTORIAL) HERNIATION through tentorial notch. (3) UNCAL (LATERAL MASS) HERNIATION over edge of tentorium. (4) CEREBELLAR TONSILLAR HERNIATION through foramen magnum. (5) TRANSCALVARIAL HERNIATION - swollen brain herniates through any defect in dura & skull. (2) - (4) types may cause death through brainstem compression. Cushing&;s triad is response to diminished brain stem perfusion, regardless of etiology. Reference: GHAI Essential pediatrics, 8th edition