AEMCA Practice Exam

What is NOT a sign of cerebral herniation?

1. Dilated, non-reactive pupils

2. Asymmetric pupil response

3. Normal reflexes

4. Posturing

The correct answer is: Normal reflexes

Normal reflexes are not a sign of cerebral herniation because, in cases of such severe brain displacement, reflexes would typically be altered or diminished. Cerebral herniation occurs when pressure within the skull increases to the point that brain tissue is forced into areas it should not occupy, leading to significant neurological deficits. This condition generally affects involuntary physiological functions, including reflexes. In contrast, dilated, non-reactive pupils, asymmetric pupil responses, and posturing are all indicative of increased intracranial pressure and potential brain injury. The presence of dilated, non-reactive pupils often suggests brainstem dysfunction. Asymmetric pupil responses can point to localized brain injury or pressure on one side of the brain, while abnormal posturing reflects serious impairment of motor pathways in the brain. Thus, normal reflexes stand out as an absence of the expected neurological changes commonly associated with herniation.