Experimental Brain Compression

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Abstract
Introduction Alterations in consciousness and nonfocal abnormalities of the electroencephalogram in patients with supratentorial mass lesions are varied and inconstant, and appear to bear no direct relationship to the site of compression or the degree of raised intracranial pressure. Several previously anomalous features of space-occupying lesions above the tentorium have proved to be due to disordered function in the brain stem, which is distorted secondarily to transtentorial herniation of the temporal lobe. Meyer first described this herniation in 1920, but clinicopathological correlations were surprisingly slow to accumulate after this important publication. Kernohan and Woltman drew attention in 1929 to ipsilateral hemiplegia due to indentation of the crus cerebri by the tentorial edge. It was another 10 years before Reid and Cone (1939) showed experimentally that the dilated pupil associated with rapid cerebral compression (e.g., due to extradural hematoma) was related to the temporal hernia displacing the trunk of the third