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Vol. 55, No. 4, 2006
Issue release date: August 2006
Eur Neurol 2006;55:230–232
(DOI:10.1159/000093876)

Kernohan’s Notch

Pearce J.M.S.
Emeritus Consultant Neurologist, Department of Neurology, Hull Royal Infirmary, Hull, UK
email Corresponding Author

Abstract

James Collier, in 1904, gave one of the best early accounts of tonsillar herniation as a terminal event caused by raised intracranial pressure. He also observed false localizing signs. Adolf Meyer added to the picture, describing detailed pathology of tentorial and subfalcial herniation, and hemianopia as a false localizing sign. In 1929, Kernohan and Woltman published their important work on ipsilateral hemiplegia accompanying expanding brain lesions. They demonstrated grooving of the crus cerebri on the side opposite to a tumour. Jefferson devised the term ‘the tentorial pressure cone.’ The current debate about the mechanisms is indicated in this short review.


 Outline


 goto top of outline Key Words

  • Tonsillar herniation
  • Tentorial pressure cone
  • Temporal lobe herniation
  • Uncus
  • False localizing signs

 goto top of outline Abstract

James Collier, in 1904, gave one of the best early accounts of tonsillar herniation as a terminal event caused by raised intracranial pressure. He also observed false localizing signs. Adolf Meyer added to the picture, describing detailed pathology of tentorial and subfalcial herniation, and hemianopia as a false localizing sign. In 1929, Kernohan and Woltman published their important work on ipsilateral hemiplegia accompanying expanding brain lesions. They demonstrated grooving of the crus cerebri on the side opposite to a tumour. Jefferson devised the term ‘the tentorial pressure cone.’ The current debate about the mechanisms is indicated in this short review.

Copyright © 2006 S. Karger AG, Basel


 goto top of outline Author Contacts

J.M.S. Pearce
304 Beverley Road
Anlaby, East Yorks HU10 7BG (UK)


 goto top of outline Article Information

Received: March 1, 2006
Accepted: March 2, 2006
Published online: June 14, 2006
Number of Print Pages : 3


 goto top of outline Publication Details

European Neurology

Vol. 55, No. 4, Year 2006 (Cover Date: August 2006)

Journal Editor: Bogousslavsky, J. (Lausanne)
ISSN: 0014–3022 (print), 1421–9913 (Online)

For additional information: http://www.karger.com/ENE


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

James Collier, in 1904, gave one of the best early accounts of tonsillar herniation as a terminal event caused by raised intracranial pressure. He also observed false localizing signs. Adolf Meyer added to the picture, describing detailed pathology of tentorial and subfalcial herniation, and hemianopia as a false localizing sign. In 1929, Kernohan and Woltman published their important work on ipsilateral hemiplegia accompanying expanding brain lesions. They demonstrated grooving of the crus cerebri on the side opposite to a tumour. Jefferson devised the term ‘the tentorial pressure cone.’ The current debate about the mechanisms is indicated in this short review.



 goto top of outline Author Contacts

J.M.S. Pearce
304 Beverley Road
Anlaby, East Yorks HU10 7BG (UK)


 goto top of outline Article Information

Received: March 1, 2006
Accepted: March 2, 2006
Published online: June 14, 2006
Number of Print Pages : 3


 goto top of outline Publication Details

European Neurology

Vol. 55, No. 4, Year 2006 (Cover Date: August 2006)

Journal Editor: Bogousslavsky, J. (Lausanne)
ISSN: 0014–3022 (print), 1421–9913 (Online)

For additional information: http://www.karger.com/ENE


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.