Cortical laminar necrosis: on MRI
NIDDM patient presented to the ER complaining of acute onset of recurrent attacks of nausea, vomiting, generalized weakness, dizziness and headache. Last similar episode was 6 days ago. He was confused during MRI study.
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MRI brain showing high signal selectively in T1 and T1 C+ along cortical and subcortical regions of right side superior, middle and inferior temporal gyri suggesting cortical laminar necrosis. Absent gyral hyperintensity on T2 sequences as well as DWI suspicious for acute or late acute stage of necrosis. Absence of cortical atrophy excludes chronic stage as well.
Note signal intensity (SI) changes of right IJV on axial T1 C+ due to CVP insertion.
Red lines on sagittal T1 C+ denote different levels of temporal gyral necrosis.