Cortical Laminar necrosis in a patient with chronic cerebral infarction; Case report

Cortical laminar necrosis (CLN) is a persistent ischemic injury attributed to a particular pan necrosis of the cerebral cortex (comprising neurons, glia, and blood vessels although underline white matter is totally or partially spared). CLN is represented radiologically by the typical curvilinear gyriform distribution high signal intensity cortical lesions on T1 weighted MRI images in the affected cerebral convolutions. This is a case of cortical laminar necrosis following old left temporo-parietal ischemic infarction. A 67-year male patient with a prior history of old left temporo-parietal ischemic infarction came for follow up MRI for old right-sided hemiplegia and aphasia. He was diabetic and hypertensive. MRI Brain images showed large old left temporo-parietal ischemic infarction in the territory of Lt. MCA. There is associated subacute ischemic infarct at the left occipital cortex. There is laminar linear cortical hyperintensity in T1WI following gyral distribution, accompanied by loss of the volume of the underlying cortex at the left temporo-parieto-occipital region suggesting cortical laminar necrosis and this picture appeared two months following old cerebral infarction and shortly the patient died.