Cortical involvement of both cerebral hemispheres, particularly in the insula and frontoparietal regions, with increased signal on T2-weighted sequences in cortical gray matter.
On T1-weighted sequences, there are areas of high signal in the cortical region of the right fronto-parietal transition (pre and post-central gyrus this side), and the gradient echo sequence is hypointense in these topographies, suggesting bleeding.
There is a mild enhancement of cortical vessels in the affected areas after the use of intravenous contrast.
There is restriction in DWI sequence.
No evidence of changes in the brainstem and cerebellar hemispheres.
All the findings are suggestive of bilateral cortical laminar necrosis, affecting the insula and frontal-parietal transitions, probably related to the vulnerability of intra-cortical border areas by anoxia, ischemia or depletion of glucose.