Kernohan-Woltman Notch Phenomenon Following Acute Subdural Hematoma

World Neurosurg. 2024 Jan:181:145-146. doi: 10.1016/j.wneu.2023.10.121. Epub 2023 Oct 26.

Abstract

A 72-year-old right-handed female patient was operated on for left-sided acute subdural hematoma responsible for coma. Two weeks afterward, her neurological status had improved with a Glasgow Coma Scale score of 14 and a paradoxical left-sided hemiparesis. The brain magnetic resonance imaging displayed a diffusion-restricting, hyper fluid-attenuated inversion recovery lesion of the right cerebral peduncle facing the tentorial notch, and the patient was diagnosed with Kernohan-Woltman notch phenomenon. This allowed to focus the neurological rehabiliation on the ipsilateral motor deficit as well as the hemineglect.

Keywords: Acute subdural hematoma; Craniotomy; Kernohan-Woltman.

MeSH terms

  • Aged
  • Brain / pathology
  • Cerebral Peduncle*
  • Female
  • Head / pathology
  • Hematoma, Subdural, Acute* / diagnostic imaging
  • Hematoma, Subdural, Acute* / etiology
  • Hematoma, Subdural, Acute* / surgery
  • Humans
  • Magnetic Resonance Imaging / methods