Brain magnetic resonance imaging and neuropathology of cortical laminar necrosis

• Published in: Revue neurologique 2007-03, Vol.163 (3), p.365-368
• Main Authors: Laksiri, N, Kaphan, E, Pellissier, J F, Ali Chérif, A
• Format: Article
• Language: fre
• Subjects: Amnesia - etiology; Brain - pathology; Cerebral Cortex - pathology; Delirium - etiology; Hernia, Umbilical - complications; Humans; Hypoxia, Brain - pathology; Magnetic Resonance Imaging; Male; Middle Aged; Necrosis; Postoperative Complications - pathology
• ISSN: 0035-3787
• DOI: 10.1016/S0035-3787(07)90410-5

The most frequent acute and sub-acute complications of chronic alcoholism are delirium tremens, hepatic encephalopathy and Gayet-Wernicke encephalopathy. Morel laminar sclerosis is a rare and less known complication, often reported with Marchiafava-Bignami disease. A 57-year-old alcoholic man presented delirium after surgery. Anterograde and retrograde amnesia as well as wrong recognitions appeared progressively and one generalized seizure occurred. He then developed mutism and became bedridden. Magnetic resonance imaging (MRI) showed high-intensity bilateral temporoparietal signals from white matter on T2-weighted images and high-intensity signals from the parietal cortex on T1-weighted images. The patient died four months after the onset of the delirium. Post-mortem examination of the brain showed cortical laminar necrosis with Alzheimer Type II gliosis but without demyelinisation of the corpus callosum. Cortical laminar necrosis with chronic ethylism is usually called Morel's laminar sclerosis. Nevertheless, histology is not typical of this diagnosis, because of necrosis especially of the second (and not the third) layer of the cortex, and because of the absence of lesion of the corpus callosum. MRI data are of interest here because they were rarely reported in cases of Morel's laminar sclerosis.