title: Kernohan-Woltman notch phenomenon caused by an acute subdural hematoma.
abstract: Uncal herniation through the tentorial notch is occasionally associated with false localizing ipsilateral hemiparesis, known as the Kernohan-Woltman notch phenomenon (KWNP). We report an 81-year-old female who presented with a decreased level of consciousness, a right mydriasis and an ipsilateral motor deficit caused by a large right hemispheric subdural hematoma that was immediately evacuated. The patient recovered well, although her right hemiplegia persisted. A follow-up MRI showed a residual lesion in the left cerebral peduncle, corresponding to KWNP. The presence of such a structural lesion suggests a poor prognosis for recovery from the initial motor deficit.
authors.affiliation: Department of Neurosurgery, La Princesa University Hospital, C/- Diego de León 62, 28006 Madrid, Spain. rocamo@gmail.com
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Carrasco
authors.forename: José M
authors.initials: JM
authors.lastname: Pascual
authors.forename: Marta
authors.initials: M
authors.lastname: Navas
authors.forename: Pedro
authors.initials: P
authors.lastname: Martínez-Flórez
authors.forename: Rafael
authors.initials: R
authors.lastname: Manzanares-Soler
authors.forename: Rafael G
authors.initials: RG
authors.lastname: Sola
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D020199:Hematoma, Subdural, Acute / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D013681:Tegmentum Mesencephali / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods