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KMID : 1034720190110020182
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Journal of Neurosonology and Neuroimaging
2019 Volume.11 No. 2 p.182 ~ p.185
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Kernohan-Woltman Notch Phenomenon Caused by a Traumatic Epidural Hematoma
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Lee Jin-Hyung
Kang Mi-Ri
Kim Sang-Jin
Yoo Bong-Goo
Kim Eung-Gyu
Ji Ki-Hwan
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Abstract
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The Kernohan-Woltman notch phenomenon is one of the false localizing signs and hinders physicians’ accurate judgment of lesion localization. The Kernohan- Woltman notch phenomenon has been rarely reported in patients with acute cerebral hemorrhage, especially acute or subacute traumatic subdural hemorrhage. The mechanism is a transtentorial herniation squeezing the opposite side of the cerebral crus against the tentorial edge of the cerebellum. If the brain image and neurological examination are inconsistent in a patient with traumatic brain injury, the Kernohan-Woltman notch phenomenon should be in the list of differential diagnoses. Herein, we present the case of a 25-year-old woman with epilepsy who presented with ipsilateral limb weakness caused by an acute traumatic epidural hematoma associated with seizure attack.
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KEYWORD
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Traumatic brain injury, Hemiparesis, Epidural hematoma, Diagnostic errors, Neurologic examination
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