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Here is a quick mnemonic “CEREBRAL MASS LESIONS to remember about Coma Due to Cerebral Mass Lesions and Herniation Syndromes

This can be valuable for patients as well as medical doctors, nurses & students doing their clinical rounds. You can also find it very useful for med exams like USMLE, MBBS, NEET PG, FMGE, NExT, MCAT & NCLEX exams

Coma Due to Cerebral Mass Lesions : How To Remember Easily ?

  • C – Compartments in the cranium restrict displacement of brain tissue.
  • E – External compression of brain tissue causes herniation.
  • R – Specific clinical features are characteristic of herniation configurations.
  • E – Enlargement of the ipsilateral pupil is a sign of uncal herniation.
  • B – Brainstem displacement leads to a Babinski sign and ipsilateral hemiparesis.
  • R – Resultant brain infarction may occur due to compression of cerebral arteries.
  • A – Anterior and posterior cerebral arteries may be compressed.
  • L – Lateral displacement of the midbrain causes coma.
  • M – Medial temporal gyrus (uncus) impacts the tentorial opening in uncal herniation.
  • A – Accompanying contralateral hemiparesis often occurs with hemispheral lesion.
  • S – Subarachnoid space compression leads to enlargement of the ipsilateral pupil.
  • S – Specific neurologic signs correspond to each level of herniation.
  • L – Late respiratory center involvement in the herniation syndrome.
  • E – Entrapment of ventricular system causes hydrocephalus.
  • S – Sequence of signs corresponds to the affected level of herniation.
  • I – Initial damage occurs in the midbrain during central transtentorial herniation.
  • O – Other forms of herniation include transfalcial and foraminal herniation.
  • N – Neurologic signs progress with compression of the brainstem.
  • S – Sparing of respiratory centers until late in the herniation syndrome.


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department