1. If using this method, be sure to punch the holes from the opposite side and snip off the punched pieces of lead to avoid having them come loose inside the frame.

2. If the lesion affects the PPRF (or the abducens nucleus) and the MLF on the same side (the MLF having crossed from the opposite side), then the "one and a half syndrome" occurs, with paralysis of all conjugate horizontal eye movements other than abduction of the eye on the opposite side to the lesion.