Cortical Laminar Necrosis in Computed Tomography Scan: A Case Report

Abstract

Introduction: Cortical laminar necrosis is an imaging term used to describe gyriform hyperdense lesions in the cortical region that can be appreciated on the CT (Computed Tomography). The etiology of this finding involves brain energy depletion, which can be derived from multiple pathologies, that mainly lead to hypoxia or metabolic alterations. Case report: the case of a 3-month-old female patient is presented; she was taken to the emergency department with a 1-week clinical manifestations consisting of thermal rises, dyspnea, cyanosis coldness in extremities, tachypnea, tachycardia and edema. An echocardiography diagnosed myocarditis of probable viral origin. Subsequently, the patient presented cardiac arrest and prolonged shock that required cardiopulmonary resuscitation and admission to neonatal ICU. A cerebral CT scan taken 1 week after these events evidenced imaging findings compatible with cortical laminar necrosis. Discussion: There are no epidemiological descriptions of this finding, however, an increase has been theorized due to the high survival rates of patients suffering from ischemic hypoxic pathologies. Although findings of cortical laminar necrosis are typical of MRI, they can also be seen on CT scan, where they typically show as a subtle cortical hyperdensity, and the most striking findings are associated to a worst prognosis. Conclusion: Disclosure of these type of radiological images is necessary in order to promote more accurate prognoses in patients in whom these findings are appreciated.