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翻訳と辞書　辞書検索 [ 開発暫定版 ] スポンサード リンク Kernohan's notch ： ウィキペディア英語版 Kernohan's notch Kernohan's notch is a cerebral peduncle indentation associated with some forms of transtentorial herniation (uncal herniation). It is a secondary condition caused by a primary injury on the ''opposite'' hemisphere of the brain.〔Wolf et al, 1995〕 Kernohan's notch is an ipsilateral condition, in that a left-sided primary lesion (in which Kernohan's notch would be on the right side) evokes motor impairment in the left side of the body and a right-sided primary injury evokes motor impairment in the right side of the body.〔Pearce, 2006〕 The seriousness of Kernohan's notch varies depending on the primary problem causing it, which may range from benign brain tumors to advanced subdural hematoma. ==Mechanism== Kernohan's notch phenomenon is a result of the compression of the cerebral peduncle, which is part of the mesencephalon, against the tentorium cerebelli due to transtentorial herniation. This produces ipsilateral hemiparesis or hemiplegia〔Moon, 2006〕 The skull is an incompressible closed space with a limited volume (Monro-Kellie Doctrine). When there is increased cranial pressure in the brain, a shift in the brain forms towards the only opening of the skull, the foramen magnum. Thus, when an increase of pressure in a hemisphere of the brain exists, the cerebral peduncle on the opposite hemisphere is pushed up against the tentorium, which separates the posterior fossa from the middle fossa. This produces a visible "notch" in the cerebral peduncle.〔 Because of the fact that a Kernohan's notch is caused by an injury creating pressure on the opposite hemisphere of the brain, it is characterized as a false localizing sign.〔 The Kernohan's notch phenomenon is unique in that it is not only a false localizing sign, but is also ipsilateral or same-sided. The left cerebral peduncle contains motor fibers that cross over to the right side of the body. Thus, if you have a right hemisphere trans-tentorial herniation, it causes a Kernohan's notch in the left cerebral peduncle which results in right-sided motor impairment. Therefore you get, paradoxically, impairment of motor function on the same side of the body as the herniation which caused the Kernohan's notch on the controlateral side.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Kernohan's notch」の詳細全文を読む スポンサード リンク 翻訳と辞書 : 翻訳のためのインターネットリソース Copyright(C) kotoba.ne.jp 1997-2016. All Rights Reserved.