Kernohan’s NotchPearce J.M.S.
Emeritus Consultant Neurologist, Department of Neurology, Hull Royal Infirmary, Hull, UK
304 Beverley Road
Anlaby, East Yorks HU10 7BG (UK)
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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.
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