Presentation
History of stroke.
Patient Data
Head NECT shows gyriform hyperdensity in the right anterior frontal upper convexity region, of uncertain etiology. Subarachnoid hemorrhage seems less plausible since the hyperdensity is intra-axial. Subtle partly calcified neoplasm (oligodendroglioma)? Cortical laminar necrosis? Further investigations recommended with MRI.
Not shown here but T2*GRE sequences showed blooming in the corresponding anterior frontal upper convexity and in the left parietal region.
The gyriform hyperdensity seen on the CT-scan is rather subtle on the T1 & T2 ponderation. The FLAIR sequence shows gyriform intra-cortical hypersignal in the corresponding territory. In combination with blooming seen on T2*GRE, this is compatible with cortical laminar necrosis.
Otherwise, there is mixed supratentorial brain atrophy with moderate leucoaraiosis.