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6/27/091
“Neurological signs
that determine ofthe site or place of any process or lesion”
“ Neurological signs that reflectdysfunction distant or remote fromexpected anatomical locus ofpathology by clinicoanatomicalcorrelation “
False localizing signassociated withintracranial lesion
Sixth nerve palsyFifth and seventhnerve palsyThird nerve palsy andKernohan’s notchphenomenonOther false localizingsign reported withintracranial pathology
False localizingsigns associatedwith spinal cordlesions
Foramen magnumand upper cervicalcord lesionsLower cervical cordand upper thoraciccord lesions
 
Unilateral or bilateral
 
Most common falselocalizing sign of intracranialtumor , IICP
 
Pathophysiology
 
Stretch nerve or compress against petrousligament or ridge ofpetrous temporal bone
 
Mechanical effects ofbackward brainstemdisplacement byintracranial spaceoccupying lesion
 
6/27/092
 
Hypoactive or hyperactive withnegative or positiveJacksonian symptoms
 
Trigeminalneuropathy ,facialpaisy
 
Trigeminalneuralgia ,Hemifacialspasm
 
Trigeminal neuropathy , facial palsy
 
Causes
 
Posterior fossa tumor 
 
Diffuse neoplastic disease
 
Idiopathic intracranial hypertension
 
Pathology
 
Traction CN in brainstem distortion from tumor 
 
Trigeminal neuralgia , hemifacial spasm
 
Causes
 
Posterior fossa tumor 
 
Causes
 
IICP
 
Hutchison ‘s pupil
 
Uncal herniation
 
Contralateral hemiparesis + IpsilateralCN III palsy
 
Ipsilateral hemiparesis + Ipsilateral CN IIIpalsy“ Kernohan’s notch phenomenon”
 
Dynamic axial brainstem distortion{Transtentorial herniation}
 
Trochlear nerve palsy : IICP
 
Unilateral hearing loss : Idiopathicintracranial hypertension
 
Unilateral papilloedema : Foster Kennedy syndrome
 
Unilateral ,ipsilateral optic atrophy
 
Contralateral papilloedema
 
Central scotoma
 
Anosmia
 
Glossopharyngeal ,Vagus nerve palsy :posterior fossa tumor 
 
Frontal ataxia : cerebellar ataxia involvecorticopontocerebellar pathway
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