[A case of hypoxic encephalopathy with unilateral laminar necrosis]

We reported a 67-year-old woman with unilateral laminar necrosis caused by hypoxic encephalopathy. She presented with sudden onset of dyspnea, unconsciousness and left hemiplegia. Although diffusion-weighted MRI image of the brain 14 hours after onset was indistinct, MRI on the 4th day showed right laminar necrosis. Cerebral angiography demonstrated complete obstruction of the right proximal common carotid artery and severe stenosis of the left internal carotid artery. We speculate that chronic ipsilateral obstruction of the internal carotid artery may modify the unique distribution of laminar necrosis. As shown in this case, laminar necrosis can be demonstrated only on subsequent MRI. If clinical suspicion of hypoxic encephalopathy is high, repeated MRI may be appropriate.