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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2019; 38(01): 056-059
DOI: 10.1055/s-0036-1593975
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Kernohan-Woltman Notch Phenomenon—Case Report

Fenômeno do entalhe de Kernohan-Woltman—relato de caso
Carlos Umberto Pereira
1   Neurosurgery Service, Hospital de Urgência de Sergipe, Aracaju, SE, Brazil
2   Department of Neurosurgery, Fundação de Beneficência Hospital de Cirurgia, Aracaju, SE, Brazil
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Further Information

Publication History

22 March 2016

30 May 2016

Publication Date:
05 December 2016 (online)

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Abstract

The Kernohan-Woltman notch phenomenon is a paradoxical neurological manifestation consisting of a motor deficit ipsilateral to a primary brain injury. It has been observed in patients with brain tumors and with supratentorial hematomas. It is considered a false localizing neurological sign. Magnetic resonance imaging (MRI) scan has been the test of choice. The recognition of this phenomenon is important to prevent a surgical procedure on the opposite side of the lesion. The present case report describes a case of chronic subdural hematoma with a probable finding of the Kernohan-Woltman phenomenon, and it discusses its pathophysiology, imaging findings, treatment, and prognosis.

Resumo

O fenômeno do entalhe de Kernohan-Woltman é uma manifestação neurológica paradoxal que consiste em um déficit motor homolateral à lesão cerebral primária. Este fenômeno tem sido observado em casos de neoplasia cerebral e de hematomas supratentoriais, e é considerado um sinal de falsa localização neurológica. Ressonância magnética tem sido o exame de escolha. É importante o reconhecimento deste fenômeno para evitar um procedimento cirúrgico no lado oposto à lesão. O presente relato de caso apresenta um caso de hematoma subdural crônico, com provável achado do fenômeno de Kernohan-Woltman, e discute sua fisiopatologia, seu achado de imagem, seu tratamento e prognóstico.

Keywords

cerebral peduncle - head injury - Kernohan-Woltman notch phenomenon - transtentorial herniation

Palavras-chave

pedúnculo cerebral - traumatismo cranioencefálico - fenômeno do entalhe de Kernohan-Woltman - herniação transtentorial
 

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