The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9452377 | PMC |
http://dx.doi.org/10.3340/jkns.2022.0002 | DOI Listing |
ACS Appl Mater Interfaces
January 2025
Université de Caen Normandie, ENSICAEN, CNRS, LCS, 14000 Caen, France.
Tumor hypoxia significantly limits the effectiveness of radiotherapy, as oxygen is crucial for producing cancer-killing reactive oxygen species. To address this, we synthesized nanosized faujasite (PBS-Na-FAU) zeolite crystals using clinical-grade phosphate-buffered saline (PBS) as the solvent, ensuring preserved crystallinity, microporous volume, and colloidal stability. The zeolite nanocrystals showed enhanced safety profiles and , and studies showed no apparent toxicity to animals.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Neurology, Inner Mongolia Autonomous Region People's Hospital, Hohhot, China.
Acute internal carotid artery occlusion (AICAO) can result in malignant cerebral edema and unfavorable patient outcomes. This study evaluated the utility of transcranial Doppler (TCD) in assessing contralateral flow compensation and predicting outcomes in patients with AICAO. We enrolled 51 patients within 6 h of symptom onset and conducted TCD examinations to evaluate collateral circulation.
View Article and Find Full Text PDFJ Neurooncol
January 2025
Department of Neurosurgery, School of Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.
Background And Objectives: Recently, reduction of transcallosal inhibition by contralateral navigated repetitive transcranial magnetic stimulation (nrTMS) improved neurorehabilitation of glioma patients with new postoperative paresis. This multicentric study examines the effect of postoperative nrTMS in brain tumor patients to treat surgery-related upper extremity paresis.
Methods: This is a secondary analysis of two randomized and three one-arm studies in brain tumor patients with new/progressive postoperative paresis.
NMR Biomed
March 2025
Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain.
Hemodynamic measurements such as cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) can provide useful information for the diagnosis and characterization of brain tumors. Previous work showed that arterial spin labeling (ASL) in combination with vasoactive stimulation enabled simultaneous non-invasive evaluation of both parameters, however this approach had not been previously tested in tumors. The aim of this work was to investigate the application of this technique, using a pseudo-continuous ASL (PCASL) sequence combined with breath-holding at 3 T, to measure CBF and CVR in high-grade gliomas and metastatic lesions, and to explore differences across tumoral-peritumoral regions and tumor types.
View Article and Find Full Text PDFSci Rep
January 2025
Neurocomputation and Neuroimaging Unit (NNU), Freie Universität Berlin, Berlin, Germany.
We are not only passively immersed in a sensorial world, but we are active agents that directly produce stimulations. Understanding what is unique about sensory consequences can give valuable insight into the action-perception-cycle. Sensory attenuation is the phenomenon that self-produced stimulations are perceived as less intense compared to externally-generated ones.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!