BRAIN - Lamina Necrosis

The specimen consists of three slices of brain sectioned within the coronal plane. The gyri are flattened and the meninges have a cloudy appearance. There are extensive areas of softening with atrophy of the grey matter throughout the parietal, temporal and occipital lobes. Areas of softening are also seen in the left cingulate gyrus and in the right basal ganglia. Sections taken from the brain showed loss of neurons within the grey matter and associated reactive gliosis. The features are those of lamina necrosis of the cerebral cortex.
This 13-year-old male was first admitted at the age of ten following a grand mal fit which resulted in hemiparesis. A CT scan at that time revealed a right occipital infarct. Further grand mal fits were noted two years later and anti-epileptic treatment instituted. At that time he was found to have Wolff-Parkinson-White syndrome on ECG. Three days prior to death and three years from initial diagnosis, he was again admitted with vomiting and fitting. His clinical state deteriorated, he became unconscious and died. It is presumed that the anoxic cerebral damage was a consequence of syncope related to the Wolff-Parkinson-White syndrome.