Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface
- Section 1 Bilateral Predominantly Symmetric Abnormalities
- Section 2 Sellar, Perisellar and Midline Lesions
- Section 3 Parenchymal Defects or Abnormal Volume
- Section 4 Abnormalities Without Significant Mass Effect
- Section 5 Primarily Extra-Axial Focal Space-Occupying Lesions
- Section 6 Primarily Intra-Axial Masses
- Section 7 Intracranial Calcifications
- 184 Congenital Cytomegalovirus Infection
- 185 Congenital Toxoplasmosis
- 186 Aicardi–Goutieres Syndrome
- 187 Physiologic Basal Ganglia Calcifications
- 188 Hyperparathyroidism
- 189 Meningioangiomatosis
- 190 Vascular Wall Calcification
- 191 Dystrophic Calcifications
- 192 Calcified Aneurysms
- 193 Vascular Malformations
- 194 Cysticercosis
- 195 Calcified Metastases
- 196 Ganglioglioma
- 197 Oligodendroglioma
- 198 Cortical Tubers in Tuberous Sclerosis
- 199 Subependymal Nodules in Tuberous Sclerosis
- 200 Ependymoma
- 201 Lipoma With Calcification
- 202 Craniopharyngioma
- 203 Meningioma
- 204 Teflon Granuloma
- Index
- References
187 - Physiologic Basal Ganglia Calcifications
from Section 7 - Intracranial Calcifications
Published online by Cambridge University Press: 05 August 2013
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface
- Section 1 Bilateral Predominantly Symmetric Abnormalities
- Section 2 Sellar, Perisellar and Midline Lesions
- Section 3 Parenchymal Defects or Abnormal Volume
- Section 4 Abnormalities Without Significant Mass Effect
- Section 5 Primarily Extra-Axial Focal Space-Occupying Lesions
- Section 6 Primarily Intra-Axial Masses
- Section 7 Intracranial Calcifications
- 184 Congenital Cytomegalovirus Infection
- 185 Congenital Toxoplasmosis
- 186 Aicardi–Goutieres Syndrome
- 187 Physiologic Basal Ganglia Calcifications
- 188 Hyperparathyroidism
- 189 Meningioangiomatosis
- 190 Vascular Wall Calcification
- 191 Dystrophic Calcifications
- 192 Calcified Aneurysms
- 193 Vascular Malformations
- 194 Cysticercosis
- 195 Calcified Metastases
- 196 Ganglioglioma
- 197 Oligodendroglioma
- 198 Cortical Tubers in Tuberous Sclerosis
- 199 Subependymal Nodules in Tuberous Sclerosis
- 200 Ependymoma
- 201 Lipoma With Calcification
- 202 Craniopharyngioma
- 203 Meningioma
- 204 Teflon Granuloma
- Index
- References
Summary
Specific Imaging Findings
Physiologic parenchymal calcifications are generally confined to the globi pallidi, but can be seen elsewhere in the basal ganglia, and in the cerebellar dentate nuclei. They are typically punctate or smudgy and almost always bilateral. Occasionally they can be quite prominent. T1 and T2 signal intensities vary depending on the concentration of calcium salts within the tissues. T2*-weighted sequences demonstrate blooming with signal loss due to increased magnetic susceptibility.
Pertinent Clinical Information
Basal ganglia calcifications are an incidental finding in roughly 1% of head CTs. They generally occur over the age of 30 and their prevalence increases with age. The median age at which physiologic basal calcification is seen is in the 60s. They usually have no clinical significance. However, if they are observed in patients with extrapyramidal signs or under the age of 30, clinical evaluation to rule out an underlying endocrine process affecting calcium and phosphate metabolism should be undertaken.
Differential Diagnosis
Fahr Disease
• also involves cerebral white matter and cerebellum
Hyperparathyroidism, Hypoparathyroidism (188)
• may involve thalamus, white matter, cerebellum, and dura
• abnormal serum PTH levels
Aicardi–Goutières Syndrome (186)
• also thalamic, periventricular and cerebellar calcifications
• leukodystrophy with abnormal white matter signal
• cerebral atrophy
• presents in infancy
Radiation/Chemotherapy-Induced Leukoencephalopathy (26, 191)
• CT hypodense and T2 hyperintense white matter
• typically in young children
• calcifications are primarily in the white matter
Congenital HIV Infection
• also frontal white matter and cerebellar calcifications
- Type
- Chapter
- Information
- Brain Imaging with MRI and CTAn Image Pattern Approach, pp. 387 - 388Publisher: Cambridge University PressPrint publication year: 2012