False Localizing Sign

The Kernohan syndrome results from the compression of the cerebral peduncle against the tentorium cerebelli. This phenomenon represents a relevant clinical sign of transtentorial herniation due to an ipsilateral expansive lesion. We reported a case of a 50-year-old woman with a right temporal meningioma who developed a false localizing hemiparesis, which improved after microsurgical resection. This case emphasizes the mechanism and rarity of this pathology.

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Kernohan’s Notch: A Forgotten Cause of Hemiplegia—CT Scans Are Useful in This Diagnosis

Case Reports in Medicine ◽

10.1155/2013/296874 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Ragesh Panikkath ◽

Deepa Panikkath ◽

Sian Yik Lim ◽

Kenneth Nugent

Keyword(s):

Computed Tomography ◽

Subdural Hematoma ◽

The Body ◽

Ct Scans ◽

Cerebral Lesion ◽

Midline Shift ◽

Tentorium Cerebelli ◽

False Localizing Sign ◽

Ipsilateral Hemiparesis

Hemiparesis ipsilateral to a cerebral lesion can be a false localizing sign. This is due to midline shift of the midbrain resulting in compression of the contralateral pyramidal fibers on the tough dural reflection tentorium cerebelli. This may result in partial or complete damage to these fibers. Since these fibers are destined to cross in the medulla and innervate the opposite side of the body, this causes hemiparesis ipsilateral to the site of cerebral lesion. Computed tomography (CT) scans have not been used to support the diagnosis of this entity until now. We report a 68-year-old woman with a subdural hematoma who developed ipsilateral hemiparesis without any other explanation (Kernohan’s notch). The CT of the head showed evidence of compression of the midbrain contralateral to the hematoma and was useful in the diagnosis. The purpose of this report is to increase the awareness of this presentation and to emphasize the utility of CT scans to support the diagnosis.

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Microsurgical Resection of a Left Cerebral Peduncle Cavernous Malformation: 3-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opz160 ◽

2019 ◽

Author(s):

Guilherme H W Ceccato ◽

Marcio S Rassi ◽

Luis A B Borba

Keyword(s):

Cavernous Malformation ◽

Cerebral Peduncle ◽

3 Dimensional ◽

Microsurgical Resection

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Subcutaneous emphysema as the first relevant clinical sign of complicated tubercular lymph node disease in a child

BMC Infectious Diseases ◽

10.1186/1471-2334-13-461 ◽

2013 ◽

Vol 13 (1) ◽

Author(s):

Susanna Esposito ◽

Alberto Giannini ◽

Pietro Biondetti ◽

Nicola Bonelli ◽

Mario Nosotti ◽

...

Keyword(s):

Lymph Node ◽

Clinical Sign ◽

Subcutaneous Emphysema ◽

Lymph Node Disease ◽

Node Disease ◽

Relevant Clinical Sign

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Reversal of Fixed Pupils after Spontaneous Intraventricular Hemorrhage with Secondary Acute Hydrocephalus: Report of Two Cases Treated with Early Ventriculostomy

Neurosurgery ◽

10.1227/00006123-198606000-00017 ◽

1986 ◽

Vol 18 (6) ◽

pp. 777-780 ◽

Cited By ~ 1

Author(s):

Seth M. Hochman

Keyword(s):

Clinical Sign ◽

Intraventricular Hemorrhage ◽

Obstructive Hydrocephalus ◽

Acute Hydrocephalus ◽

Transtentorial Herniation ◽

Aggressive Management ◽

Rapid Reversal ◽

Male Patients

Abstract Rapid reversal of fixed pupils, complete external 3rd nerve ophthalmoplegia, and coma occurred after early ventricu-lostomy in two hypertensive male patients with spontaneous intraventricular hemorrhage and secondary acute hydro-cephalus. Putative pathophysiology of fixed pupils secondary to transtentorial herniation from obstructive hydrocephalus is discussed. Cases such as the present ones are unsettling because they are exceptions to the usually reliable negative prognosis indicated by fixed puplis. Nonetheless, it is important to report these cases to delineate which patients with this important clinical sign may benefit from aggressive management.

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