False localizing signs in traumatic brain injury.
BACKGROUND
Hemiparesis ipsilateral to a mass-occupying lesion can be due to Kernohan-Woltman Notch Phenomenon (KWNP). This syndrome implies a false-localizing sign because clinical findings lead the examiner to an incorrect neuroanatomical diagnosis. The contralateral crus cerebri (pyramidal tract) is pressed against the tentorial incisum and a resultant hemiparesis is found on the same side of the lesion.


METHODS
A detailed literature search of false-localizing signs is presented.


CONCLUSIONS
Not infrequently, patients presenting to a physiatrist may have incomplete records. The existence of false localizing signs may point the physician towards the wrong underlying pathology.
McKenna
Cristin
C
Kessler Institute for Rehabilitation, West Orange, NJ 07052, USA. cmckenna@kmrrec.org
Fellus
Jonathan
J
Barrett
Anna M
AM
D001930:Brain Injuries / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D002983:Clinical Competence / Q000592:standards; D003937:Diagnosis, Differential; D006801:Humans; D010291:Paresis / Q000175:diagnosis* / Q000503:physiopathology