PMID: 9161379May 1, 1997Paper

Kernohan-Woltman notch phenomenon: an unusual cause of ipsilateral motor deficit

Archives of Physical Medicine and Rehabilitation
R D Zafonte, C Y Lee

Abstract

Posttraumatic ipsilateral motor deficits are rare and raise etiologic and prognostic concerns for the rehabilitation team. We present two cases with an unusual central neurologic cause of ipsilateral weakness. The first patient was assaulted, with a resultant severe traumatic brain injury. Initial computed tomography showed a large right subdural hematoma (SDH) with significant mass effect. Following a craniotomy for evacuation of the SDH, the patient was noted to have paradoxical right-sided (ipsilateral) motor deficits. Postoperative magnetic resonance imaging (MRI) showed compression of the contralateral (left) cerebral peduncle against the tentorium, thus resulting in ipsilateral (right-sided) motor weakness (the Kernohan-Woltman notch phenomenon). Prior limited reports carried a grave prognosis for these patients. On discharge from inpatient rehabilitation, the patient was functioning at a Rancho Los Amigos Scale VI. The second patient was involved in a motor vehicle accident and was found to have a large left frontotemporal subdural hematoma with shift. A dense left hemiplegia was noted after hematoma evacuation. MRI also showed a right cerebral peduncle hypointensity. At discharge, the patient was rated a Rancho Los Amig...Continue Reading

References

Apr 1, 1979·Neurosurgery·B JennettT Kurze
Jan 1, 1991·Annals of the New York Academy of Sciences·R W ThatcherP Krause
Apr 1, 1989·Radiology·L R GentryB H Thompson
Mar 1, 1988·AJR. American Journal of Roentgenology·L R GentryB Thompson
Dec 1, 1983·Journal of Neurosurgery·K J van DongenG J Gelpke
Sep 1, 1996·American Journal of Physical Medicine & Rehabilitation·R D ZafonteS R Millis

❮ Previous
Next ❯

Citations

Sep 1, 1999·Clinical Neurology and Neurosurgery·L MastronardiA Guiducci
Apr 22, 1999·Postgraduate Medical Journal·J S Mehta, M M Sharr
Jun 27, 2009·Brain Injury : [BI]·Cristin McKennaAnna M Barrett
Sep 8, 2007·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kyung-Sub MoonSam-Suk Kang
Feb 6, 2015·Clinical Neuroradiology·M ÇabalarV Yayla
Jun 22, 2013·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Seong-il OhHee-Jin Kim
Oct 27, 2016·British Journal of Neurosurgery·C H ZhangG Critchley
Jan 28, 2014·Annals of Rehabilitation Medicine·Seung-Gul Jang, Sung-Bom Pyun
Sep 15, 2020·British Journal of Neurosurgery·Boyi LiFawaz Al-Mufti
Apr 14, 2020·American Journal of Physical Medicine & Rehabilitation·Kayli Gimarc, Teresa L Massagli

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.