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- Rodrigo Carrasco, José M Pascual, Marta Navas, Pedro Martínez-Flórez, Rafael Manzanares-Soler, and Rafael G Sola.
- Department of Neurosurgery, La Princesa University Hospital, C/- Diego de León 62, 28006 Madrid, Spain. rocamo@gmail.com
- J Clin Neurosci. 2009 Dec 1;16(12):1628-31.
AbstractUncal 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.
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