Presentation
Three days after cardiac arrest. Patient with persistent coma.
Patient Data
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 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.