calsefication

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PUBLICATION DATA
Accepted 16 July 2012
Published online 1st November 2012.
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• Calcification was presumed when there were
  abnormal areas of high density calcification,
  within the brain parenchyma.
• ICC may have no clinical importance or they may
  be critical findings in
• diagnosing the underlying pathology.

Definitions Intracranial calcification ICC
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• Patients were grouped into diagnostic categories
  where a definitive molecular diagnosis was known,
  or where the clinical and radiological features
  suggested a specific diagnosis with a high
  probability.
• For patients where the diagnosis was unknown, we
  defined subgroups according to shared
  radiological features.
• In some of these groups the radiological and
  clinical features were suggestive of a discrete
  aetiology
• . However, because these designations are
• putative at this stage, these patients were
  classified in the
• unknown category. The primary diagnostic
  categories are

Diagnostic categories
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(a) spots
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(b) lines
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(c) rock
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(d) blush
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(e) gyriform/ band-like
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(f) reticular
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Etiology
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Basal ganglia calcification
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physiologic calcifications

• very common And associated with aging .
• Seen in
• Falx / tentorium dural calcifications in
  children should raise the suspicion of underlying
  pathology, mainly basal-cell nevus syndrome.
• Cerebellum dentate nucleus most common site.
• arachnoid granulations.

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• pineal gland 40 of normal people by the age of
  20 years lt 1cm
• choroid plexus 2 of children between 0 to 8y
  and 9.5 9 to 15 years of age.
• basal ganglia in patients lt30 years of age
  should prompt careful clinical evaluation to rule
  out another etiology

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Dystrophic calcifications

• chronic sequelae -------- often associated with
  encephalomalacia and reactive gliosis.
• trauma, surgery
• ischemia
• radiation chemo therapy

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Three main types ofcalcifications have been
observed

• mineralizing microangiopathy, which
• affects small arteries and arterioles,
  resulting in basal ganglia and subcortical
  white-matter calcifications.
• necrotizing leukoencephalopathy,
• which results in white-matter calcifications
  in the posterior hemisphere.
• dystrophic brain calcifications.

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Congenital disorders/phakomatosE

• group of hereditary disorders that affect
  structures of ectodermal origin.

• tuberous sclerosis------ Calcified subependymal
  hamartomas located along the ventricular surface
  of the caudate nucleus .
• Sturge-Weber syndrome---- The parieto-occipital
  cortex is the most
• common location , 20 are bilateral.
• basal-cell nevus syndrome -- younger age groups.
  
• Early dural calcifications falx , diaphragma
  sella and tentorium.

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Vascular calcifications

• vascular malformations an aneurysms.
• seen in watershed or other areas away from AVM
  nidus due to ischemic brain tissue as a result of
  the vascular steal

round lesion with rim calcifications in
suprasellar region
suprasellar region no enhancement of the round
calcified lesion.
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• Cavernous angiomas
• stippled calcifications in the vessel wall or
  the adjacent brain parenchyma.

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Congenital infections

• Basal ganglia and cortical calcifications are
  common features of all infections that constitute
  the TORCH syndrome .

Congenital toxoplasmosis

• dense calcifications in the
• basal ganglia
• subcortical white matter bilaterally.
• brain volume loss with
• colpocephaly.

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• Congenital Cytomegalovirus
• Periventricular calcification

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• Congenital HIV infection
• is associated with periventricular frontal
  white-matter and cerebellar calcifications

calcifications in subcortical white matter of
frontal lobes and dentate nucle
calcifications in basal ganglia bilaterally.
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Acquired infections
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Inflammatory lesions
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Intra-axial tumors
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Tumors
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Extra-axial tumors
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Intraventricular tumors
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Endocrine/metabolic/idiopathic
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Conclusion

• Knowledge of physiologic calcifications in the
  brain parenchyma is essential to avoid
  misinterpretations.
• several pathologic conditions involving the
  brain are associated with calcifications .
• recognition of their appearance and distribution
  helps narrow the differential diagnosis.