Cortical laminar necrosis: on MRI

Case contributed by Dr Mohamed Hossam el Deen

Presentation

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.

Patient Data

Age: 50 years
Gender: Male

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.

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Case information

rID: 46893
Published: 21st Jul 2016
Last edited: 8th Dec 2019
Inclusion in quiz mode: Included

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