C.N.S.Intracranial Calcifications

Mohamed Zaitoun

Assistant Lecturer-Diagnostic Radiology Department , Zagazig University Hospitals

EgyptFINR (Fellowship of Interventional

Neuroradiology)-Switzerlandzaitoun82@gmail.com

Knowing as much as possible about your enemy precedes successful battle

and learning about the disease process precedes successful management

Intracranial Calcificationsa) Normal Variantb) Vascularc) Tumorsd) Infectione) Neurocutaneous Syndromesf) Basal Ganglia Calcification

a) Normal Variant :1-Pineal :-After 10 years of age on SXR , earlier on CT2-Choroid Plexus :-Trigones of lateral ventricles -Unusual in 3rd & 4th ventricles3-Dura :-Falx & tentorium

4-Basal Ganglia :-Globus pallidus , usually bilateral5-Habenular Commisure :-C-shaped calcification in tela choroidea of 3rd

ventricle6-Dentate nuclei of cerebellum7-Parasellar Ligaments8-Arachnoid Granulations

b) Vascular :1-Atherosclerosis in vertebrobasilar and carotid

vessels at skull base2-AVM3-Cavernoma4-Aneurysms , mural calcification in giant

aneurysms5-Chronic subdural hematoma6-Old infarct or hematoma

c) Tumors :1-Meningioma2-Oligidendroglioma , 50 % calcify3-Astrocytoma4-Low grade glioma5-Craniopharyngioma6-Metastases , adenocarcinoma (GIT & breast ,

especially after therapy in breast)

7-Pineal region tumors , teratoma & germinoma8-Chordoma & chondrosarcoma9-Fatty midline tumors , dermoid & lipoma of

corpus callosum10-Choroid plexus papilloma11-DNET12-Central Neurocytoma

d) Infection :1-TORCH2-Cysticercosis :-Periventricular , cisternal & nodules at grey-

white matter junction with nidus of calcification

3-T.B. :-Basal cisterns , ventricles & parenchyma

e) Neurocutaneous Syndromes :1-Sturge Weber syndrome :-Subcortical tramline calcification2-Tuberous Sclerosis :-Periventricular & parenchymal3-Neurofibromatosis :-Choroid plexus , subependymal & basal ganglia

f) Basal Ganglia Calcification : ( See Bilateral basal Ganglia Abnormalities )

1-Normal variant2-Endocrine :-Hypoparathyroidism , pseudohypoparathyroidism

& hypothyroidism3-Metabolic :-Mitochondrial disorders ( Leigh’s disease ) , Fahr’s

disease & Cockayne’s syndrome

4-Toxins :-Carbon monoxide , lead & posth-ypoxic5-Post-therapeutic :-Mineralizing angiopathy following

chemotherapy or radiation in basal ganglia , dentate nuclei of cerebellum and cortico-medullary junction