Cerebral Atrophy in Torture Victims

To the Editor: The letter by Jensen and co-workers in the November 18 issue¹ described cortical or central atrophy on CT scans of torture victims. We would like to suggest a possible mechanism to explain these CT-scan findings, assuming that they cannot be attributed to an obvious cause, such as repeated head trauma. High cortisol levels may be related to cerebral ventricular enlargement (i.e., central atrophy) seen on CT scans in some psychiatric patients. It is known that patients with Cushing's disease and those receiving exogenous steroids have both cortical and central atrophy on CT scan that is reversible.