Cerebral Infarction with Haemorrhagic Transformation and Cortical Laminar Necrosis Induced by Inhalation of Nitrous Oxide: A Case Report

Abstract

Abstract Background: The abuse of nitrous oxide, commonly known as laughing gas, has emerged as a significant social and public dilemma. Nitrous oxide abuse can induce anaemia, pneumothorax, thrombosis, and various neurological complications. Haemorrhagic transformation is a common occurrence in the natural progression of cerebral infarction and represents a significant adverse effect of treatments such as thrombolysis. This is strongly linked to the poor prognosis of cerebral infarction. Cortical laminar necrosis is a type of ischaemic necrosis with a laminar pattern in the cortex resulting from hypoperfusion caused by different aetiologies. Instances of cerebral infarction caused by N2O abuse are rare, and cerebral infarction accompanied by haemorrhagic transformation and cortical laminar necrosis has not been reported. Case presentation: We present the case of a 27-year-old man who experienced syncope, hemiparesis, and aphasia as a direct result of excessive N2O inhalation. A sizeable cerebral infarction with haemorrhagic transformation in the left frontoparietotemporal insula and basal ganglia, along with laminar necrotic changes in the cortex, was found. Conclusions: Attention should be paid to the unique complications resulting from N2O abuse while enhancing our understanding of the causes and imaging features of cortical laminar necrosis.