Brain herniation due to brain hemorrhage refers to the displacement of the patient’s brain tissue due to the hematoma-dominant effect of the brain hemorrhage and the edema that can occur around the patient’s hematoma, resulting in compression of the patient’s brain tissue. For example, if a patient has a hemorrhage in the supratentorial hemisphere, the hematoma may squeeze down on the lower thalamus and brainstem, resulting in deformation and displacement of the thalamus and brainstem, called a cerebellar canopy herniation, or a central herniation if the brain hemorrhage causes a downward displacement of the midline structures. If the patient has a significant increase in intracranial pressure or if there is a large bleed in the cerebellum, the patient may develop a foramen occipitalis herniation. Either way, the clinical risk of brain herniation is high and the patient may die quickly. In the early stages of herniation, the patient may have a dilated pupil on one side, and craniotomy should be considered to remove the hematoma and save the patient.