IMAGING OF INTRACRANIAL CALCIFICATIONS

1. PHYSIOLOGICAL AND
PATHOLOGICAL
CALCIFICATION OF BRAIN
Dr.I.Gurubharath MD PhD Dr.Pooja MD

3. pineal gland
• Seen in 2/3 of the
adult population
• Increases with
age
• Calcification over
1cm in diameter
or under nine
years old may be
suggestive of a
neoplasm

5. habenULA
• It has a central role in
the regulation of the
limbic system
• It is often calcified with
a curvilinear pattern a
few millimeters
anterior to the pineal
body in 15% of the
adult population

6. choroid plexus
• Very common
finding, usually in
the atrial portions
of the lateral
ventricles
• Calcification in the
third or fourth
ventricle
• Patients less than
nine years of age is
uncommon

7. basal gangliA
• Are usually incidental
idiopathic findings that
have an incidence of
~1% (range 0.3-1.5%)
and increases with age
• faint punctuate or a
coarse conglomerated
symmetrical calcification
pattern

8. petroclinoid ligaments
Common age-related
degeneration sites and
usually have laminar or mildly
nodular patterns

9. superior sagittal sinus
• Common age-related degeneration sites
• usually have laminar or mildly nodular
patterns

10. Falx dura mater or tentorium cerebelli
• In ~10% of the elderly
population
• Dural and tentorial
calcifications are
usually seen in a
laminar pattern and
can occur anywhere
within the cranium

11. CT axial view
showing
calcification
along the
tentorium
cerebelli

12. dentate nuclei of cerebellum
CT axial view showing
bilateral dentate nucleus
calcification

16. Tumors
Craniopharyngioma
Glioma
Meningioma
Ependyomoma
Papilloma of choroid plexus
Pinealoma
Chordoma
Dermoid, epidermoid & teratoma
hamartoma

17. CT axial view
showing partially
cystic,cortex based
mass with nodular
calcification in the
right temporal lobe
suggestive of
ganglioglioma

18. CT axial view showing Craniopharyngiomas in two
different patients in sellar and suprasellar regions with
amorphous calcifications.

19. CT axial view
showing heavy
calcification in the
right frontal lobe
suggestive of
oligodendrogliomas.

20. Bone window
unenhanced
CT image
demonstrates
a meningioma
as a dural-
based cortical
mass with
dense
globular
calcification in
the frontal

21. vascular malformation
• Aneurysm
• Angioma
• Atheroma

22. Unenhanced axial
CT scan shows a
giant aneurysm with
a rim like calcified
wall arising from the
ACA(arrow).Calcific
ation in right MCA
walls (arrow heads),
surrounding edema,
and hydrocephalus
with intra-ventricular
hemorrhage
(dashed arrow) are
also seen.

24. Primary atherosclerotic calcified plaques are
demonstrated on the walls of the interanal carotid (a)
and bilateral vertebral arteries (arrows) (b, c)

25. infection
• Neurocysticercosis
• Cerebral toxoplasmosis
• Cytomegalic inclusion body disease
• Herpes
• Rubella
• Tuberculosis
• Pyogenic abscess
• Trichinosis

27. Axial unenhanced
CT shows
extensive bilateral
thalamic and
periventricular
calcifications
associated with
dilated ventricular
asymmetry in
congenital

28. Axial CT shows
extensive
periventricular
calcifications with
marked
hydrocephaly in
congenital
Cytomegalovirus
infection.

29. Congenital
• Sturge-Weber syndrome,
• tuberous sclerosis,
• Neurofibromatosis
• lipoma

31. Unenhanced axial
CT showing
characteristic gyral
calcifications in
Struge-Weber
syndrome
associated with
atrophy of the right
frontal and temporal

32. CT axial view
showing
intracranial lipoma
in midline of
cerebrum with thin
focal
calcifications(arro
ws)

33. Metabolic and miscellaneous
• Hypoparathyroidism
• Pseudohypoparathyroidism
• Fahr disease
• Lissencephaly
• Radiation
• Hemodialysis
• Lead poisoning
• CO poisoning

36. REFERENCES:
1. Osborn AG, Hedlund GL, Salzman KL. Osborn's brain:
imaging, pathology, and anatomy. Salt Lake City: Amirsys;
2013.
2. Adam A, Dixon AK, Gillard JH, Schaefer-Prokop C,
Grainger RG, Allison DJ. Grainger & Allison's Diagnostic
Radiology E-Book. Elsevier Health Sciences; 2014 Jun 16.
3. Dahnert WF. Radiology review manual. Lippincott Williams
& Wilkins; 2017 Mar 9.
4. www.Radiopedia.org