Laminar cortical necrosis

Case contributed by Dr Paul Simkin

Presentation

Generalized lethargy. Previous stroke 2 month earlier.

Patient Data

Age: 80 years
Gender: Female
ct

Gyriform high density in the right parietal and temporal lobes, with underlying white matter hypodensity, correlate to the regions of ischemia seen on the previous MRI.

DWI from MRI 2 months earlier

mri

Several areas of restricted diffusion in the right frontal lobe, right insula, right parietal lobe are in keeping with acute infarctions in the right MCA territory. The largest focal areas of diffusion restriction are in the right parietal lobe, however there are punctate foci elsewhere in the MCA territory.

CT from 2 months earlier

ct

There is subtle hypoattenuation and loss of grey-white matter differentiation in the posterior right insular cortex and superior temporal lobe.

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