Pupillary changes of tentorial notch hernia

Tentorial notch hernia, also known as temporal sulcus hernia, is a space-occupying lesion in one hemisphere that causes persistent compression and displacement of brain tissue, mainly in the sulcus gyrus of the medial temporal lobe, compressing the midbrain and oculomotor nerve from the midbrain, resulting in significant pupil changes. In the early stages of the disease, oculomotor nerve stimulation may manifest as pupil contraction, but this process is extremely short and rarely detected. More often, it is manifested as pupil dilation on the affected side, accompanied by mental disorder and coma. If the disease continues to develop, it will manifest bilateral pupil dilation, resulting in life threatening.