• 제목/요약/키워드: cerebellar herniation

검색결과 5건 처리시간 0.022초

Contralateral Superior Cerebellar Artery Syndrome : A Consequence of Brain Herniation

  • Mohseni, Meysam;Habibi, Zohreh;Nejat, Farideh
    • Journal of Korean Neurosurgical Society
    • /
    • 제60권3호
    • /
    • pp.362-366
    • /
    • 2017
  • Vascular compromise is a well-known consequence of brain herniation syndromes. Transtentorial brain herniation most often involves posterior cerebral arteries. However, isolated involvement of contralateral superior cerebellar artery (SCA) during unilateral impending brain herniation is reported only once and we present another case of this exceedingly rare entity. A 24-year-old man was referred to us with impending herniation due to a multiloculated hydrocephalus, and during the course of illness, he developed an isolated SCA ischemia in the opposite side of the most dilated entrapped horn. In the current article we discuss the probable pathophysiologic mechanisms of this phenomenon, as well as recommending more inclusive brain studies in cases suspected of Kernohan-Woltman notch phenomenon in unilateral brain herniation. The rationale for this commentary is that contralateral SCA transient ischemia or infarct might be the underdiagnosed underlying pathomechanism of ipsilateral hemiparesis occurring in many cases of this somehow vague phenomenon.

자기공명영상을 이용한 24마리의 개에서의 Chiari 1형 유사 기형 진단 (Magnetic Resonance Imaging in 24 Dogs with Chiari type 1-like Malformations)

  • 최호정;이영원
    • 한국임상수의학회지
    • /
    • 제23권2호
    • /
    • pp.91-95
    • /
    • 2006
  • 사람에서, Chiari 1형 기형은 소뇌 탈출과 척수공동증이 특정인 발달성 장애이다. 이러한 사람의 Chiari 1형 기형과 유사한 질환이 cavalier King Charles spaniels에서 흔히 나타났다. 그러나, 이러한 Chiari 1형 유사 기형이 다른 종의 개에서 진단 보고된 증례가 거의 없는 실정이다. 이에 본 연구에서는 24 마리의 개에서 자기공명영상 장치를 이용하여 Chiari 1형 유사 기형으로 진단된 증례를 보고하고자 한다. 이 개들은 다양한 신경 증상과 다양한 정도의 소뇌 탈출, 척수공동증, 두개관내 거미막 낭종 또는 뇌수종의 병발 질환들을 나타내었다.

Remote Cerebellar Hemorrhage after Intradural Disc Surgery

  • Yoo, Je Chul;Choi, Jeong Jae;Lee, Dong Woo;Lee, Sangpyung
    • Journal of Korean Neurosurgical Society
    • /
    • 제53권2호
    • /
    • pp.118-120
    • /
    • 2013
  • We report a rare case of remote cerebellar hemorrhage after intradural disc surgery at the L1-2 level. Two days after the spine surgery, patient complained unexpected headache, dizziness, nausea and vomiting. From the urgently conducted brain CT, it was reported that the patient had cerebellar hemorrhage. Occipital craniotomy and hematoma evacuation was performed, and hemorrhagic lesion on the right cerebellum was effectively removed. After occipital craniotomy, the patient showed signs of improvement on headache, dizziness, nausea and vomiting. He was able to leave the hospital after two weeks of initial operation without any neurological deficit. Remote cerebellar hemorrhage following spinal surgery is extremely rare, but may occur from dural damage of spinal surgery, accompanied with cerebrospinal fluid leakage. Early diagnosis is particularly important for the optimal treatment of remote cerebellar hemorrhage.

Type I Chiari malformation presenting orthostatic syncope who treated with decompressive surgery

  • Shin, Hyun-Seung;Kim, Jeong A;Kim, Dong-Seok;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
    • /
    • 제59권sup1호
    • /
    • pp.149-151
    • /
    • 2016
  • Chiari malformations are a congenital anomaly of the hindbrain. The most common, Chiari malformation type I (CM-I), is characterized by herniation of the cerebellar tonsils extending at least 3 mm below the plane of the foramen magnum. Consequently, CM-I is associated with hydrocephalus and symptoms involving compression of the cervicomedullary junction by ectopic tonsils. Several studies have reported the clinical symptoms associated with CM-I, including suboccipital headache, weakness in the upper extremities, facial numbness, loss of temperature sensation, ataxia, diplopia, dysarthria, dysphagia, vomiting, vertigo, nystagmus, and tinnitus. Syncope is one of the rarest presentations in patients with CM-I. There are many hypotheses regarding the causes of syncope in patients with CM-I; however, the mechanisms are not clearly understood. Although surgical decompression for CM-I in patients with syncope has yielded good clinical results in some studies, such cases are rarely reported. We report a case of orthostatic syncope in a patient with CM-I who was treated with surgical intervention.

The Kernohan-Woltman Notch Phenomenon : A Systematic Review of Clinical and Radiologic Presentation, Surgical Management, and Functional Prognosis

  • Beucler, Nathan;Cungi, Pierre-Julien;Baucher, Guillaume;Coze, Stephanie;Dagain, Arnaud;Roche, Pierre-Hugues
    • Journal of Korean Neurosurgical Society
    • /
    • 제65권5호
    • /
    • pp.652-664
    • /
    • 2022
  • 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.