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Contralateral Superior Cerebellar Artery Syndrome: A Consequence of Brain Herniation Publisher



Mohseni M1 ; Habibi Z2 ; Nejat F2
Authors
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Authors Affiliations
  1. 1. Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Pediatric Neurosurgery, Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Korean Neurosurgical Society Published:2017


Abstract

Vascular compromise is a well-known consequence of brain herniation syndromes. Transtentorial brain herniation most often involves posterior cerebral arteries. However, isolated involvement of contralateral superior cerebellar artery (SCA) during unilateral impending brain herniation is reported only once and we present another case of this exceedingly rare entity. A 24-year-old man was referred to us with impending herniation due to a multiloculated hydrocephalus, and during the course of illness, he developed an isolated SCA ischemia in the opposite side of the most dilated entrapped horn. In the current article we discuss the probable pathophysiologic mechanisms of this phenomenon, as well as recommending more inclusive brain studies in cases suspected of Kernohan-Woltman notch phenomenon in unilateral brain herniation. The rationale for this commentary is that contralateral SCA transient ischemia or infarct might be the underdiagnosed underlying pathomechanism of ipsilateral hemiparesis occurring in many cases of this somehow vague phenomenon. © 2017 The Korean Neurosurgical Society.