C.N.S.
Intracranial Calcifications
Mohamed Zaitoun
Assistant Lecturer-Diagnostic Radiology
Department , Zagazig University Hospitals
Egypt
FINR (Fellowship of Interventional
Neuroradiology)-Switzerland
zaitoun82@gmail.com
Knowing as much as
possible about your enemy
precedes successful battle
and learning about the
disease process precedes
successful management
Intracranial Calcifications
a) Normal Variant
b) Vascular
c) Tumors
d) Infection
e) Neurocutaneous Syndromes
f) Basal Ganglia Calcification
a) Normal Variant :
1-Pineal :
-After 10 years of age on SXR , earlier on CT
2-Choroid Plexus :
-Trigones of lateral ventricles
-Unusual in 3rd
& 4th
ventricles
3-Dura :
-Falx & tentorium
4-Basal Ganglia :
-Globus pallidus , usually bilateral
5-Habenular Commisure :
-C-shaped calcification in tela choroidea of 3rd
ventricle
6-Dentate nuclei of cerebellum
7-Parasellar Ligaments
8-Arachnoid Granulations
b) Vascular :
1-Atherosclerosis in vertebrobasilar and carotid
vessels at skull base
2-AVM
3-Cavernoma
4-Aneurysms , mural calcification in giant
aneurysms
5-Chronic subdural hematoma
6-Old infarct or hematoma
c) Tumors :
1-Meningioma
2-Oligidendroglioma , 50 % calcify
3-Astrocytoma
4-Low grade glioma
5-Craniopharyngioma
6-Metastases , adenocarcinoma (GIT & breast ,
especially after therapy in breast)
7-Pineal region tumors , teratoma & germinoma
8-Chordoma & chondrosarcoma
9-Fatty midline tumors , dermoid & lipoma of
corpus callosum
10-Choroid plexus papilloma
11-DNET
12-Central Neurocytoma
d) Infection :
1-TORCH
2-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 calcification
2-Tuberous Sclerosis :
-Periventricular & parenchymal
3-Neurofibromatosis :
-Choroid plexus , subependymal & basal ganglia
f) Basal Ganglia Calcification : ( See Bilateral basal
Ganglia Abnormalities )
1-Normal variant
2-Endocrine :
-Hypoparathyroidism , pseudohypoparathyroidism
& hypothyroidism
3-Metabolic :
-Mitochondrial disorders ( Leigh’s disease ) , Fahr’s
disease & Cockayne’s syndrome
4-Toxins :
-Carbon monoxide , lead & posth-ypoxic
5-Post-therapeutic :
-Mineralizing angiopathy following
chemotherapy or radiation in basal ganglia ,
dentate nuclei of cerebellum and cortico-
medullary junction
Diagnostic Imaging of Intracranial calcifications

Diagnostic Imaging of Intracranial calcifications

  • 1.
  • 2.
    Mohamed Zaitoun Assistant Lecturer-DiagnosticRadiology Department , Zagazig University Hospitals Egypt FINR (Fellowship of Interventional Neuroradiology)-Switzerland zaitoun82@gmail.com
  • 5.
    Knowing as muchas possible about your enemy precedes successful battle and learning about the disease process precedes successful management
  • 6.
    Intracranial Calcifications a) NormalVariant b) Vascular c) Tumors d) Infection e) Neurocutaneous Syndromes f) Basal Ganglia Calcification
  • 7.
    a) Normal Variant: 1-Pineal : -After 10 years of age on SXR , earlier on CT 2-Choroid Plexus : -Trigones of lateral ventricles -Unusual in 3rd & 4th ventricles 3-Dura : -Falx & tentorium
  • 8.
    4-Basal Ganglia : -Globuspallidus , usually bilateral 5-Habenular Commisure : -C-shaped calcification in tela choroidea of 3rd ventricle 6-Dentate nuclei of cerebellum 7-Parasellar Ligaments 8-Arachnoid Granulations
  • 9.
    b) Vascular : 1-Atherosclerosisin vertebrobasilar and carotid vessels at skull base 2-AVM 3-Cavernoma 4-Aneurysms , mural calcification in giant aneurysms 5-Chronic subdural hematoma 6-Old infarct or hematoma
  • 10.
    c) Tumors : 1-Meningioma 2-Oligidendroglioma, 50 % calcify 3-Astrocytoma 4-Low grade glioma 5-Craniopharyngioma 6-Metastases , adenocarcinoma (GIT & breast , especially after therapy in breast)
  • 11.
    7-Pineal region tumors, teratoma & germinoma 8-Chordoma & chondrosarcoma 9-Fatty midline tumors , dermoid & lipoma of corpus callosum 10-Choroid plexus papilloma 11-DNET 12-Central Neurocytoma
  • 12.
    d) Infection : 1-TORCH 2-Cysticercosis: -Periventricular , cisternal & nodules at grey- white matter junction with nidus of calcification 3-T.B. : -Basal cisterns , ventricles & parenchyma
  • 13.
    e) Neurocutaneous Syndromes: 1-Sturge Weber syndrome : -Subcortical tramline calcification 2-Tuberous Sclerosis : -Periventricular & parenchymal 3-Neurofibromatosis : -Choroid plexus , subependymal & basal ganglia
  • 14.
    f) Basal GangliaCalcification : ( See Bilateral basal Ganglia Abnormalities ) 1-Normal variant 2-Endocrine : -Hypoparathyroidism , pseudohypoparathyroidism & hypothyroidism 3-Metabolic : -Mitochondrial disorders ( Leigh’s disease ) , Fahr’s disease & Cockayne’s syndrome
  • 15.
    4-Toxins : -Carbon monoxide, lead & posth-ypoxic 5-Post-therapeutic : -Mineralizing angiopathy following chemotherapy or radiation in basal ganglia , dentate nuclei of cerebellum and cortico- medullary junction