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2 LIMITS AND CONTINUITY 903 D (a, b) f () 0 L-LL z FIGURE 1 0 x L- S 0 x D y FIGURE 2 y (a, b) b 0ax FIGURE 3 If fx,ylL1 asx,yla,balongapathC1 and fx,ylL2 as x, y l a, b along a path C2, where L1 L2, then limx, yla, b fx, y does not exist.
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75 8 508. Herniation Syndrome CHAPTER 25 Type Lesion Injured Structure Clinical Presentation Uncal Hemispheric or lateral middle fossa mass Ipsilateral CN III compression and cerebral peduncle Initially: ipsilateral pupil dilated with pre- served or sluggish reaction to light Advanced stage: complete internal and external ophthalmoplegia, hemiparesis (50 ipsilateral and 50 contralateral) Central Supratentorial diffuse brain edema, hemorrhage, or midline brain tumors Initial obstructive hydrocephalus and displacement of thalamus and hypothalamus Initially: decreased consciousness, small reac- tive pupils, normal eye movements Advanced stage: unreactive mid-position pupils, ophthalmoplegia, flexor (decorticate) posturing Midbrain compression Advanced stage of uncal, central, or upward infratentorial herniation Midbrain and upper pons Extensor (decerebrate) posturing.
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