An uncal herniation, like a posterior communicating artery aneurysm, can compress the oculomotor nerve causing an ocular palsy. In such a case, the eye is pulled "down and out" with unopposed superior oblique and lateral rectus msucles, the only two muscles not innervated by the oculomotor nerve. Parasympathetic innervation to the pupil is also diminished from this which causes a dilated pupil. This condition is not consistent with the H-test in this patient though. Return to the case to reconsider other options.