What symptoms may occur due to tentorial herniation?

Tentorial herniation occurs when brain tissue is displaced due to increased intracranial pressure, leading to a critical condition characterized by the movement of the brain across the tentorium cerebelli, a structure that separates the cerebellum from the occipital lobe. One of the hallmark symptoms of this type of herniation is the presence of pupillary changes. This is due to the pressure exerted on the oculomotor nerve (CN III), which controls various functions of the eye, including pupillary constriction. As the herniation progresses, the oculomotor nerve can become compromised, leading to dilation of the pupil on the side of the herniation, as well as possible ptosis (drooping of the eyelid) and impaired eye movement.

Recognizing these symptoms is crucial, as they indicate a significant neurological compromise and the need for immediate medical intervention. In contrast, the other options describe symptoms that do not specifically relate to tentorial herniation. Severe neck stiffness and fever may suggest meningitis, cognitive disorientation and hallucinations could be attributed to various neurological conditions or toxicological issues, and numbness with lower back pain is more likely related to spinal cord issues rather than direct effects of