Brain cortical laminar necrosis

Case contributed by Bruno Di Muzio
Diagnosis almost certain


Three days after cardiac arrest. Patient with persistent coma.

Patient Data

Age: 70 years
Gender: Male

There is a diffuse effacement of the CSF-containing spaces (see previous CT below), decreased cortical gray matter attenuation with loss of normal gray-white differentiation and linear hyperdensity outlining the cortex that corresponds to cortical laminar necrosis.

4 mth before brain CT


CT without significant findings, just for comparison to the current CT scan.

Case Discussion

Cardiac arrest maybe is the most characteristic example of causes of hypoxic-ischemic brain damage.

The vulnerability of cortical layers 3, 4, and 5 to anoxia and ischemia, due to its higher metabolic demands, is the cause of cortical laminar necrosis

The gyriform high attenuation is believed to be caused by the accumulation of denatured proteins in dying cells and does not represent the presence of hemorrhage.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.