Diagnosing Kernohan-Woltman notch phenomenon by Somatosensory Evoked Potentials in Intensive Care Unit

Kernohan-Woltman notch phenomenon can occur after hemispheric brain lesions with severe midline herniation. This is clinically defined by the existence of false-localizing signs (such as an ipsilateral hemiparesis) due to a contralateral mesencephalon compression by the tentorial edge, without contralateral hemiparesis by temporal lobe herniation (Codd et al., 2013). Repetitive somatosensory evoked potential (SEP) recordings have been used to help assessing secondary injury related to severe herniation on the intensive care unit (ICU), even if they were not brought to evidence by intracranial pressure (ICP) monitoring (Stocchetti et al., 2014).

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