Unilateral cerebral herniation resulting in combined contralateral superior cerebellar artery territory infarction and mesencephalic injury: Two cases of a severe unrecognized variant of Kernohan notch phenomenon?

A case of unilateral cerebral herniation due to an acute middle cerebral artery territory infarct and a second case of unilateral cerebral herniation due to an acute subdural hematoma are presented in this article. In both instances, the unilateral cerebral herniation resulted in a combined contralateral superior cerebellar artery territory infarction and mesencephalic injury. Unilateral cerebral herniation resulting in a combined contralateral superior cerebellar artery territory infarct and mesencephalic injury is previously undescribed in the literature and likely reflects a severe unrecognized variant of Kernohan notch phenomenon.