Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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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. ⋯ 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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Spontaneous cerebellar haemorrhage following spinal surgery is rare, with fewer than 20 patients reported in the literature. We present a 70-year-old woman who underwent a L5-S1 posterior lumbar interbody fusion for spondylolisthesis. ⋯ The patient became increasingly drowsy 36 hours later. She was subsequently found to have bilateral cerebellar haemorrhages with associated non-communicating hydrocephalus.
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The year 2009 marks the 100th anniversary of the first Nobel Prize to be awarded to a surgeon, Emil Theodor Kocher. Kocher was a surgical pioneer and in 1909 was awarded the Nobel Prize in Physiology or Medicine for his contributions to the understanding and treatment of the thyroid gland. ⋯ He published articles on traumatic epilepsy, brain damage and trepanation. Together with Harvey Cushing, they pioneered and expanded on research of the physiology of intracranial pressure, which led to the advent of the Cushing-Kocher theory.