Kernohan-Woltman Notch Phenomenon Caused by a Traumatic Epidural Hematoma
이진형, 강미리, 김상진, 유봉구, 김응규, 지기환,
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이진형 ( Lee Jin-Hyung )
Kosin University Gospel Hospital Department of Neurology
강미리 ( Kang Mi-Ri )
Inje University College of Medicine Busan Paik Hospital Department of Neurology
김상진 ( Kim Sang-Jin )
Inje University College of Medicine Busan Paik Hospital Department of Neurology
유봉구 ( Yoo Bong-Goo )
Kosin University Gospel Hospital Department of Neurology
김응규 ( Kim Eung-Gyu )
Inje University College of Medicine Busan Paik Hospital Department of Neurology
지기환 ( Ji Ki-Hwan )
Inje University College of Medicine Busan Paik Hospital Department of Neurology
Abstract
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.
키워드
Traumatic brain injury; Hemiparesis; Epidural hematoma; Diagnostic errors; Neurologic examination
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