Lim Nana, Lee Geunsu, Won Ki Hong, Kang Jin Sun, Lee Sunghoon, Cho Younkyung, Lee Hyun Kyung, Kang Eunyoung
Department of Rehabilitation Medicine, Kwangju Christian Hospital, Gwangju, Korea.
Korean J Neurotrauma. 2021 Mar 18;17(1):61-66. doi: 10.13004/kjnt.2021.17.e4. eCollection 2021 Apr.
Ipsilateral hemiparesis is a rare and challenging sign in clinical neurological practice. Although the etiology of this manifestation is poorly understood, recent studies have attempted to probe the pathomechanism of this sign with advanced radiological techniques. Additional knowledge about the lesion and unraveling the pathomechanisms causing neurological impairments are important to predict the prognosis and clinical course and to aid in rehabilitation. Therefore, we present a case of a patient with a traumatic subdural hematoma on the left hemisphere and left spastic hemiparesis. Using diffusion tensor imaging (DTI), we concluded that the right corticospinal tract injury caused by compression of the cerebral peduncle accounted for the ipsilateral hemiparesis, also known as Kernohan's notch phenomenon. Thus, this case report highlights the usefulness of the newer radiological techniques, such as DTI, to identify the pathomechanisms of neurological presentations.
同侧偏瘫在临床神经学实践中是一种罕见且具有挑战性的体征。尽管对这种表现的病因了解甚少，但最近的研究试图用先进的放射学技术探究该体征的发病机制。关于病变的更多知识以及阐明导致神经功能障碍的发病机制对于预测预后和临床病程以及辅助康复很重要。因此，我们报告一例左侧半球创伤性硬膜下血肿并伴有左侧痉挛性偏瘫的患者。通过扩散张量成像（DTI），我们得出结论，大脑脚受压导致的右侧皮质脊髓束损伤是同侧偏瘫的原因，这也被称为克诺汉切迹现象。因此，本病例报告强调了诸如DTI等更新的放射学技术在识别神经学表现发病机制方面的有用性。
