Diffusion tensor tractography in two cases of kernohan-woltman notch phenomenon

Seung Gul Jang, Sung Bom Pyun

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Kernohan-Woltman notch phenomenon (KWP) is an ipsilateral motor weakness due to compression of the contralateral cerebral peduncle. We report two cases of KWP following traumatic brain injury. In case 1, ipsilateral hemiplegia was noted after right subdural hemorrhage. Although magnetic resonance imaging showed no abnormal signal changes on cerebral peduncle, diffusion tensor tractography (DTT) revealed interruption of corticospinal tract (CST) at lower level of the midbrain level. In case 2, there was abnormal signal change of the right cerebral peduncle contralateral to the primary lesion and we could not reconstruct right CST. Case 1 showed unsatisfactory motor recovery even after 15 months, and follow-up DTT showed no change. In case 2, follow-up DTT was not performed, but her ipsilateral hemiparesis had almost disappeared during the 15 months. DTT would be useful in detecting ipsilateral hemiparesis due to KWP and the clinical course may differ according to the lesion characteristics.

Original languageEnglish
Pages (from-to)879-885
Number of pages7
JournalAnnals of Rehabilitation Medicine
Issue number6
Publication statusPublished - 2013 Dec


  • Diffusion tractography
  • Hemiplegia
  • Pyramidal tract
  • Traumatic brain injury

ASJC Scopus subject areas

  • Rehabilitation


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