Kernohan's notch and misdiagnosis of disorders of consciousness.

Détails

ID Serval
serval:BIB_5F5E78A9D38B
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Kernohan's notch and misdiagnosis of disorders of consciousness.
Périodique
Bmj Case Reports
Auteur(s)
Simonin A., Levivier M., Nistor S., Diserens K.
ISSN
1757-790X (Electronic)
Statut éditorial
Publié
Date de publication
2014
Volume
02
Pages
-
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Résumé
A 69-year-old man presented with a sudden headache followed by unconsciousness. There was no head injury. The Glasgow Coma Scale (GCS) score was 3/15 and there was a left mydriasis, unreactive to light. The CT-scan showed a left acute subdural haematoma causing a remarkable mass effect. A supratentorial hemispheric craniotomy was performed. Nevertheless, after several weeks at the intensive care unit (ICU), the patient was still unresponsive to external stimuli and did not show any motor activity. A comfort care attitude was decided on with the family and the patient was extubated. However, a few days later, the patient subsequently showed a surprisingly favourable course, with improved wakefulness. Indeed, the GCS score improved, and the treatment plan was modified so that the patient benefited from rehabilitation. The MRI showed a right cerebral peduncle lesion, consistent with a Kernohan-Woltman notch phenomenon (KWNP). Six months later, the patient was able to walk and live quite normally.
Mots-clé
Aged, Anisocoria/etiology, Craniotomy, Diagnostic Errors, Hematoma, Subdural, Acute/complications, Hematoma, Subdural, Acute/diagnosis, Hemiplegia/etiology, Humans, Magnetic Resonance Imaging, Male, Mydriasis/etiology, Tegmentum Mesencephali/pathology, Tomography, X-Ray Computed, Unconsciousness/diagnosis, Unconsciousness/etiology
Pubmed
Création de la notice
04/11/2014 18:01
Dernière modification de la notice
20/08/2019 15:17
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