AN UNCOMMON CAUSE OF IPSİLATERAL MOTOR DEFİCİT: “KERNOHAN WOLTMAN NOTCH PHENOMENON”

Öz

Kernohan-Woltman notch phenomenon (KWNP) is a false localising sign which may cause diagnostic confusion. KWNP is characterized by “ipsilateral” hemiparesis due to compression of the contralateral cerebral peduncle against the free edge of the tentorium, thus producing a “groove” or “notch.” In our paper, a patient with ipsilateral hemiparesis complaints after intracranial hemorrhage secondary to trauma is described. With this case, it was aimed to detect the false-localization symptom, which is defined as KWNF, as soon as possible.

Anahtar Kelimeler

• Kernohan-Woltman notch phenomenon
• false localisation
• intracranial hemorrhage
• trauma
• ipsilateral hemiparesis

İPSİLATERAL HEMİPAREZİNİN NADİR BİR SEBEBİ: “KERNOHAN WOLTMAN NOTCH FENOMENİ’’

Öz

Kernohan – Woltman Notch Fenomeni (KWNF), tanı karışıklığına sebep olabilecek bir yanlış lokalizasyon belirtisidir. KWNF kontralateral serebral pedinkülün tentoryumun serbest kenarına karşı sıkışmasına bağlı bir "oluk" veya "çentik" oluşumuna yol açarak "ipsilateral" hemiparezi ile karakterizedir. Bu yazımızda, travmaya sekonder intrakraniyal kanama sonrası aynı taraflı hemiparezi kliniğiyle başvuran bir hasta ele alınmıştır. Bu olgu ile KWNF olarak tanımlanan, yanlış lokalizasyon belirtisinin en erken sürede fark edilmesini sağlamak amaçlanmıştır.

Anahtar Kelimeler

• Kernohan-Woltman Notch Fenomeni
• yanlış lokalizasyon
• intrakraniyal hemoraji
• travma
• ipsilateral hemiparezi

Kaynakça

1. Carrasco-Moro R, Castro-Dufourny I, Martínez-San Millán JS, Cabañes-Martínez L, Pascual JM (2019). Ipsilateral hemiparesis: the forgotten history of this paradoxical neurological sign. Neurosurg Focus. 47(3):E7. Doi :10.3171/ 2019.6. FOCUS 19337
2. Gimarc K, Massagli TL.(2020) Kernohan-Woltman Notch Phenomenon in Two Patients with Subdural Hematoma and Ipsilateral Hemiparesis. Am J Phys Med Rehabil. Dec;99(12):1195-1196. doi: 10.1097/PHM.0000000000001427.
3. Özturk S, Ozturk Y, Ocal O.(2017) The First Case of Kernohan-Woltman Notch Phenomenon Caused by Epidural Hematoma in a Pediatric Patient. Pediatr Neurosurg. 52(3):181-184. doi: 10.1159/000474945.
4. Ragesh Panikkath, Deepa Panikkath, Sian Yik Lim, Kenneth Nugent(2013) "Kernohan’s Notch: A Forgotten Cause of Hemiplegia—CT Scans Are Useful in This Diagnosis", Case Reports in Medicine, vol. 2013, Article ID 296874, 3 pages, 2013. https://doi.org/10.1155/2013/296874
5. Zhang CH, DeSouza RM, Kho JS, Vundavalli S, Critchley G.(2017) Kernohan-Woltman notch phenomenon: a review article. Br J Neurosurg. 31(2):159-166. doi:10.1080/02688697.2016.1211250