Cortical laminar necrosis

Case contributed by Dr Maxime St-Amant

Presentation

R/o stroke.

Patient Data

Age: 75
Modality: CT

Head NECT shows gyriform hyperdensity in the right anterior frontal upper convexity region, of uncertain aetiology. Subarachnoid hemorrhage seems less plausible since the hyperdensity is intra-axial. Subtle partly calcified neoplasm (oligodendroglioma)? Cortical laminar necrosis? Further investigations recommended with MRI.

Modality: MRI

Not shown here but T2*GRE sequences showed blooming in the corresponding anterior frontal upper convexity and in the left parietal region.

The gyriform hyperdensity seen on the CT-scan is rather subtle on the T1 & T2 ponderation. The FLAIR sequence shows gyriform intra-cortical hypersignal in the corresponding territory. In combination with blooming seen on T2*GRE, this is compatible with cortical laminar necrosis.

Otherwise, there is a mixed supratentorial brain atrophy with moderate leucoaraiosis.

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Case Information

rID: 18928
Diagnostic certainty: Probable
Inclusion in quiz mode: Included

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