Dammers Ruben, Volovici Victor, Kompanje Erwin J O
*Department of Neurosurgery, Brain Tumor Center and ‡Department of Intensive Care, Department of Medical Ethics and Philosophy of Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Neurosurgery. 2016 Apr;78(4):581-4. doi: 10.1227/NEU.0000000000001097.
The history of false localizing signs is intimately linked to the birth of modern neurology and the unraveling of the mysteries of localization through neurological examination at the end of the 19th century. This phenomenon has attracted much attention but has not been properly explained, even in the authoritative handbooks such as that by Oppenheim. A scholarly article written by Kernohan and Woltman in 1929 is considered to be a landmark in the history of neurology and neurosurgery in that it provided the definitive answer and an exhaustive explanation of the problem, leading some neurologists to conclude that the localization of a lesion is not an exact science. However, despite the professional manner in which Kernohan and Woltman presented their case, they did not offer an explanation. In another article published 2 years earlier in 1927, Groeneveld and Schaltenbrand provided a pathophysiological and anatomical explanation of the phenomenon, described in detail. Although Kernohan and Woltman themselves refer to that previous article, it was this article that provided the first logical, clear, indubitable explanation of the phenomenon that we today refer to as the Kernohan notch.
假定位体征的历史与现代神经病学的诞生以及19世纪末通过神经学检查揭开定位之谜紧密相连。这一现象备受关注，但即便在如奥本海姆所著的权威手册中也未得到恰当解释。1929年克诺汉和沃尔特曼撰写的一篇学术文章被视为神经学和神经外科史上的一个里程碑，因为它给出了明确答案并对该问题进行了详尽解释，致使一些神经学家得出病变定位并非一门精确科学的结论。然而，尽管克诺汉和沃尔特曼专业地阐述了他们的病例，但并未给出解释。在1927年早两年发表的另一篇文章中，格罗内维尔德和沙尔滕布兰德详细提供了该现象的病理生理和解剖学解释。尽管克诺汉和沃尔特曼自己提及了那篇先前的文章，但正是这篇文章首次对我们如今所称的克诺汉切迹这一现象给出了合乎逻辑、清晰且不容置疑的解释。
