Keywords
vertex
Kernohan-Woltman knotch
How to Cite
Abstract
It is the name of the paradoxical deficit of the ipslateral hemibody at the supratentorial pressure focus, product of the compression of the cerebral peduncle contralateral to the herniation, towards the tentorial free edge and interruption of the corticospinal fibers; it is considered "a sign of false location that puts the neurologist and neurosurgeon to shame"; it is represented in the image as a notch in the affected peduncle; it is rare in epidural hematomas. This is a 33-year-old patient, who suffered an axial impact in the vertex, with an interparietal fracture that caused injury to the upper sagittal sinus in its three thirds; He attended with a Glasgow Scale of six, with anisocoria and ipsilateral hemiplegia, with biparietal epidural hematoma, repair surgery of the superior sagittal sinus and modified decompressive hemicraniectomy towards the midline, the objective is to discuss the characteristics of the trauma, management surgical and case prognosis.
References
2. Gimenez-Pando J., Cabezudo-Artero J.M., Fernández-Portales I., et al. Contralateral mesencephalic injury due to tentorial uncal herniation. Magnetic resonance imaging of the Kernohan's notch. Neurocirugia (Astur), 2004;15(4):384-387.
3. Zhang C.H., De Souza R.M., Kho J.S., Vundavalli S., Critchley G. Kernohan-Woltman notch phenomenon: a review article. Br J Neurosurg. 2017 Apr;31(2):159-166. doi: 10.1080/02688697.2016.1211250. Epub 2016 Oct 26.
4. Vengalathur Ganesan Ramesh, Marappan Kodeeswaran, Kunjithapatham Deiveegan,Venkataraman Sundar and Kuchalambal Sriram. Vertex epidural hematoma: An analysis of a large series Asian J Neurosurg. 2017 Apr-Jun; 12(2): 167–171.doi: 10.4103/1793-5482.145555
5. Neurocirugia 2017;28(Espec Congr):267 Neurocirugía (English edition) http://www.revistaneurocirugia.com C0293 - Fenómeno de Kernohan-Woltman secundario a un quiste epidermoide. J.A. Gutiérrez Cierco, R. Carrasco Moro, L.M. Rojas Medina, M. López Gutiérrez y L. Ley Urzáiz.
6. Rajaraajan K., Pragadhees R., Prabu SSS, Pradeep S. Morphometric Analysis of Tentorial Incisura and its Clinical Implications. Int J Sci Stud 2017;5(7):98-104. DOI: 10.17354/ijss/2017/504.
7. Mckenna C., Fellus J., Barrett A. False localizing signs in traumatic brain injury. Brain Inj. 2009 Jul; 23(7): 597–601. doi: 10.1080/02699050902973921
8. SERAM 2012.; S-0250 . http://dx.doi.org/10.1594/seram2012/S-0250. Hendidura de Kernohan. M. Shahin, N. Hernández Gutiérrez, E. De Antonio Sanz, J. Martínez San Millán; Madrid/ES. DOI: 10.1594/seram2012/S-0250
9. Uesugi S, Suehiro E, Nakayama H, Suzuki M. Diffusion-weighted magnetic resonance imaging in a case of Kernohan's notch phenomenon. Acta Neurochir (Wien). 2010 Oct;152(10):1809-10. doi: 10.1007/s00701-010-0732-4.
10. Yoo WK., Kim DS., Kwon YH., Jang SH. Kernohan's notch phenomenon demonstrated by diffusion tensor imaging and transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry. 2008 Nov;79(11):1295-7. doi: 10.1136/jnnp.2007.138131.
11. Binder DK., Lyon R., Manley GT. Transcranial motor evoked potential recording in a case of Kernohan's notch syndrome: case report. Neurosurgery. 2004 Apr;54(4):999-1002.
12. Moon KS., Lee JK., Joo SP., Kim TS., Jung S., Kim JH., et al. Kernohan's notch phenomenon in chronic subdural hematoma: MRI findings. Clin Neurosci. 2007 Oct;14(10):989-92.
13. Jennett B., Teasdale G., Braakman R., et al. Prognosis of patients with severe head injury. Neurosurgery. 1979;4(4):283-289.
14. Datta SGS. Bilateral vertex extradural hematomas: A case report. Indian J Neurotrauma. 2008;5:109–11
15. Behera SK, Senapati SB, Mishra SS, Das S. Management of superior sagittal sinus injury encountered in traumatic head injury patients: Analysis of 15 cases. Asian J Neurosurg. 2015;10:17–20.
16. Cohen-Gadol. Dural Venous Sinus Injury. Neurosurg Atlas.Last Updated: July 26, 2018. DOI: https://doi.org/10.18791/nsatlas.v2.14.2
17. Bullock MR., Chesnut R., Ghajar J., Gordon D., Hartl R., Newell DW., et al. Surgical management of acute epidural hematomas. Neurosurgery. 2006;58:S7–15.
18. Sindou M, Auque J. The intracranial venous system as a neurosurgeon’s perspective. Adv Tech Stand Neurosurg. 2000; 26:131–216. https://doi.org/10.1007/978-3-7091- 6323-8_5
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