Cortical laminar necrosis, also known as pseudolaminar necrosis, is necrosis of neurons in the cortex of the brain in situations when the supply of oxygen and glucose is inadequate to meet regional demands. This is often encountered in cardiac arrest, global hypoxia and hypoglycemia.
What causes laminar necrosis?
Cortical laminar necrosis is predominantly caused by hypoxia and metabolic disorders, like hypoglycemia, intoxication, hypoxic-ischemic encephalopathy, renal and hepatic dysfunction, but may also be seen in patients with encephalitis [8–10].
Does laminar necrosis enhance?
Contrast enhancement of the laminar lesions was prominent at 1-2 months and became less apparent from 3 months, but could be seen up to 8 months.
What is meant by cortical laminar necrosis?
Cortical laminar necrosis (CLN) is radiologically defined as high intensity cortical lesions on T1 weighted MRI images following a gyral distribution. Histopathologically, CLN is characterised by pannecrosis of the cortex involving neurones, glial cells, and blood vessels.
What is cortical lamination?
Definition. Lamination is the biological process by which cells are arranged in layers within a tissue during development. Laminated structures in the nervous system include the cerebral cortex, retina and hippocampus.
What is watershed area of brain?
Watershed locations are those border-zone regions in the brain supplied by the major cerebral arteries where blood supply is decreased. Watershed strokes are a concern because they comprise approximately 10% of all ischemic stroke cases.
What causes cerebral cortical necrosis?
Cortical laminar necrosis is caused by cerebral energy depletion, resulting in necrosis of particular cortical laminae. On T1-weighted MR images, hyperintense lesions are seen in the cerebral cortex during the subacute or chronic stage of brain damage.
What is chronic infarct?
Chronic ischemic infarcts are characterized by hypo density and sharply demarcated margins. As the tissue continues to break down and phagocytosis occurs, the parenchyma is replaced with a cystic CSF-filled space.
What is hemorrhagic transformation?
Hemorrhagic transformation (HT) is a common complication in patients with acute ischemic stroke. It occurs when peripheral blood extravasates across a disrupted blood brain barrier (BBB) into the brain following ischemic stroke. Preventing HT is important as it worsens stroke outcome and increases mortality.
Where is the cortical?
The cerebral cortex is the outer covering of the surfaces of the cerebral hemispheres and is folded into peaks called gyri, and grooves called sulci. In the human brain it is between two and three or four millimetres thick, and makes up 40 per cent of the brain’s mass.
