Abstract

False localization signs or paradoxical neurological findings are a manifestation of indirect dysfunction at a neurological structure remote from the location of expected anatomical pathology. We present a case of an acute subdural hematoma that caused unexpected ipsilateral hemiparesis secondary to injury of the contralateral cerebral peduncle as a result of brain shift from this mass lesion. This phenomenon is termed Kernohan’s notch. We delve further into the pathophysiology of these and pathognomonic imaging features identified in our case report.

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