Multiple cranial nerve signs from supratentorial tumors

✓ A case of sphenoid meningioma with multiple cranial nerve signs is described in which the olfactory and optic brain tracts were involved unilaterally by the local effects of the tumor. All true cranial nerves except the eleventh were bilaterally, symmetrically, and selectively involved as a result of the general pressure effects of the tumor. The mechanisms that can produce this syndrome of multiple cranial nerve failure by a sequence of various brain shifts and hernias, hydrocephalus, and foraminal impaction, are discussed and demonstrated.