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.
Keywords
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Article info
Publication history
Accepted:
February 3,
2009
Received:
November 25,
2008
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
