Brain herniation is a catastrophic sequela of increased intracranial pressure (ICP) or local mass effect from intracranial lesions. Different types of brain herniation can occur depending on the location of mass effect and how rapidly this mass effect develops.1 Any mass lesion, including hemorrhage, tumor, vasogenic or cytotoxic edema, trauma or infection can cause herniation. However spontaneous intracerebral hemorrhage (ICH) and traumatic brain injury (TBI) are common causes of herniation in the acute …