emat oma , ▁e pid ural ▁h emat oma , ▁de pressed ▁sk ull ▁f ract ure , ▁or ▁sp ont aneous ▁int rac ere br al ▁h emat oma . ▁ ▁Also , ▁it ▁is ▁important ▁to ▁note ▁that ▁the ▁an atom ical ▁size ▁of ▁tent orial ▁not ches ▁vary ▁consider ably ▁between ▁individuals ; ▁however , ▁very ▁little ▁evidence ▁supports ▁that ▁a ▁more ▁narrow ▁not ch ▁creates ▁a ▁pre dis position ▁towards ▁K ern oh an ' s ▁not ch . ▁ ▁Sign s ▁and ▁sympt oms ▁Sym pt oms ▁directly ▁related ▁to ▁the ▁K ern oh an ' s ▁not ch ▁is ▁most ▁commonly ▁par al ysis ▁or ▁weak ness ▁on ▁one ▁side ▁of ▁the ▁body ▁( ips il ater al ▁par al ysis ▁/ ▁par esis ), ▁the ▁so - called ▁K ern oh an ' s ▁sign . ▁Par al ysis ▁and ▁weak ness ▁is ▁known ▁as ▁hem i ple gia ▁and ▁hem ip ares is , ▁respectively . ▁This ▁is ▁due ▁to ▁destruction ▁or ▁pressure ▁applied ▁to ▁the ▁motor ▁fib ers ▁located ▁in ▁the ▁c ere br al ▁ped un cle . ▁A ▁more ▁rare ▁sign ▁of ▁K ern oh an ' s ▁not ch ▁is ▁i ps il ater al ▁o cul om ot or ▁n erve ▁p als y . ▁ ▁However , ▁most ▁patients ▁come ▁into ▁the ▁clin ic ▁cit ing ▁sympt oms ▁associated ▁with ▁the ▁primary ▁injury ▁causing ▁the ▁K ern oh an ' s ▁not ch . ▁Since ▁so ▁many ▁types ▁of