Brain cortical laminar necrosis

Case contributed by Dr Bruno Di Muzio


Three days after cardiac arrest. Patient with persistent coma.

Patient Data

Age: 69
Gender: Male

CT Brain

There is a diffuse effacement of the CSF-containing spaces (see previous CT below), decreased cortical gray matter attenuation with loss of normal gray-white differentiation and linear hyperdensity outlining the cortex that corresponds to cortical laminar necrosis.


Four months before patient underwent a brain CT

CT without significant findings, just for comparison to the current CT scan.

Case Discussion

Cardiac arrest maybe is the most characteristic example of causes of hypoxic-ischemic brain damage.

The vulnerability of cortical layers 3, 4, and 5 to anoxia and ischemia, due to its higher metabolic demands, is the cause of cortical laminar necrosis

The gyriform high attenuation is believed to be caused by the accumulation of denatured proteins in dying cells and does not represent the presence of hemorrhage.

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Case information

rID: 27590
Published: 9th Feb 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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