Kernohan–Woltman notch phenomenon in patient with subdural hematoma and ipsilateral hemiparesis in Bukavu

• Published in: Clinical case reports Vol. 11; no. 7; pp. e7643 - n/a
• Main Authors: Murhega, Roméo Bujiriri, Balemba Ghislain, Maheshe, Mudekereza, Paterne Safari, Musilimu, Sudi, Bisimwa, Igega, Munguakonkwa Budema, Paul, Mubenga, Léon‐Emmanuel
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-07-2023; John Wiley and Sons Inc; Wiley
• Subjects: Bukavu; Case Report; Case reports; Conflicts of interest; Consciousness; Hematoma; Hernias; Kernohan–Woltman; Localization; Magnetic resonance imaging; Medical imaging; Neurosurgery; subdural hematoma; Supervision; Writing; Kernohan–Woltman; subdural hematoma; Bukavu
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.7643

Key Clinical Message
Kernohan–Woltman phenomenon is a rare and paradoxical neurological situation in which a transtentorial lesion leads to compression of the contralateral cerebral peduncle responsible for compression of the descending corticospinal fibers with clinical consequence of a motor deficit ipsilateral to the primary lesion. This phenomenon should attract the attention of clinicians in order to avoid unfortunate incidents such as wrong‐side craniotomy in neurosurgical practice. In this work, we report a similar situation.
The Kernohan–Woltman notch phenomenon is a rare and paradoxical neurological situation in which transtentorial damage is observed leading to compression of the contralateral cerebral peduncle responsible for compression of descending corticospinal fibers with the clinical consequence of a motor deficit ipsilateral to the primary lesion. This phenomenon has been found in several situations including tumors and cerebral hematomas after craniocerebral trauma. In this work, we have reported the case of a 52‐year‐old man with hemiparesis ipsilateral to a large chronic subdural hematoma.