Abstract
Kernohan-Woltman notch phenomenon (KWNP) is an ipsilateral motor weakness due to compression of the contralateral cerebral peduncle. Most of the KWNP cases reported have been due to subdural hematomas, intracranial space-occupying lesions, and spontaneous bleeding of vascular malformations. In this study, we present the first pediatric case of KWNP caused by a traumatic epidural hematoma. Although subdural hematomas are the most frequent reason for KWNP, epidural hematomas may cause paradoxical ipsilateral signs not only in adults but also in pediatric patients.
References
1.
Kernohan JW, Woltman HW: Incisura of the crus due to contralateral brain tumor. Arch Neurol Psychiatry 1929;21:274-287.
2.
Turnbull AR: Multiple false localizing signs in intracranial tumour. Case report. J Neurosurg 1974;40:264-266.
3.
Fujimoto A, Sato H, Katayama W, Nakai K, Tsunoda T, Kobayashi E, Nose T: Kernohan's phenomenon associated with left ruptured occipital arteriovenous malformation. J Clin Neurosci 2004;11:444-446.
4.
Dibble CF, Wemhoff MP, Ibrahim T, Sasaki-Adams D, Solander S, Germanwala AV: Ruptured arteriovenous malformation presenting with Kernohan's notch. Case Rep Neurol Med 2015;2015:921930.
5.
Zhang CH, DeSouza RM, Kho JS, Vundavalli S, Critchley G: Kernohan-Woltman notch phenomenon: a review article. Br J Neurosurg 2016;26:1-8.
6.
Cohen AR, Wilson J: Magnetic resonance imaging of Kernohan's notch. Neurosurgery 1990;27:205-227.
7.
Clement VL, Sherer M: Neuropsychological findings in a patient with Kernohan's notch. Appl Neuropsychol 1996;3:55-57.
8.
Giménez-Pando J, Cabezudo-Artero JM, Fernández-Portales I, Rodríguez-Sánchez JA, Gómez-Perals L, Lorenzana L, Ugarriza F: Contralateral mesencephalic injury due to tentorial uncal herniation. Magnetic resonance imaging of the Kernohan's notch. Neurocirugia (Astur) 2004;15:384-387.
9.
Mejía Kattah J, Vilá Barriuso E, García Bernedo C, Gallart Gallego L: Kernohan-Woltman notch phenomenon secondary to a cranial epidural hematoma. Rev Esp Anestesiol Reanim 2014;61:332-335.
10.
Yogarajah M, Agu CC, Sivasambu B, Mittler MA: HbSC disease and spontaneous epidural hematoma with Kernohan's notch phenomena. Case Rep Hematol 2015;2015:470873.
11.
Lee EJ, Hung YC, Wang LC, Chung KC, Chen HH: Factors influencing the functional outcome of patients with acute epidural hematomas: analysis of 200 patients undergoing surgery. J Trauma 1998;45:946-952.
12.
Wilberger JE Jr, Harris M, Diamond DL: Acute subdural hematoma: morbidity, mortality, and operative timing. J Neurosurg 1991;74:212-218.
13.
Gurer B, Kertmen H, Yilmaz ER, Dolgun H, Hastürk AE, Şekerci Z: The surgical outcome of traumatic extraaxial hematomas causing brain herniation. Turk Neurosurg 2017;27:37-52.
14.
Adler DE, Milhorat TH: The tentorial notch: anatomical variation, morphometric analysis, and classification in 100 human autopsy cases. J Neurosurg 2002;96:1103-1112.
15.
Skadorwa T, Eibl M, Zygańska E, Ciszek B: Radiological anatomy of the ambient cistern in children. Folia Morphol (Warsz) 2010; 69:78-83.
16.
Wolf RF, ter Weeme CA, Krikke AP: Kernohan's notch and misdiagnosis. Lancet 1995; 345:259-260.
© 2017 S. Karger AG, Basel
2017
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.