False localizing signs, although rare, indicate significant increased intracranial pressure with tissue shift, has occurred. A review of the historical perspective highlights the discovery of these false localizing signs, and exploration of the anatomic and physiologic causes provides important insight for neuroscience nurses. Critical thinking skills, and a world view paradigm for clinical practice are developed upon an in-depth understanding of neurologic dysfunction. Collaborative relationships are enhanced by an interdisciplinary approach to assessment of the critically ill neuroscience patient.