Brain cortical laminar necrosis

Case contributed by Dr Bruno Di Muzio

Presentation

Three days after cardiac arrest. Patient with persistent coma.

Patient Data

Age: 69
Gender: Male
CT

CT Brain

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.

CT

Four months before patient underwent a 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 its higher metabolic demandis, is the cause of cortical laminar necrosis

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

 

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Case information

rID: 27590
Case created: 9th Feb 2014
Last edited: 10th Dec 2016
Inclusion in quiz mode: Included

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