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Pseudolaminar necrosis

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Acute cognitive decline.

Patient Data

Age: 75 years
Gender: Female
mri

T2 brightening in the right frontal lobe - note hyperintensity in the cortex on T2 and T1 without any substantial enhancement = pseudolaminar necrosis, i.e. subacute cerebral infarction. Despite increased signal on DWI, majority of the lesion shows minimal restriction of diffusion on the ADC map = probable "fogging", i.e. transition between subacute infarction and healing. Occurs between 1-5 weeks after infarction.

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