Assignment Task by Prof. Dr.

Muhammad Jamil Akhtar

 Calcium is one of the most abundant mineral in the
body. It is present in the bones, teeth, and bloodstream.
If calcium deposits form, the medical names for this is
“calcification.” The formation se calcifications in body
tissue, cause the tissues to harden and can occur in
virtually any tissue of the body.
99% of calcium entering the body is deposited in bones
and teeth. The remaining calcium dissolves in the blood.
When a disorder affects the balance between calcium
and certain chemicals in the body, calcium can be
deposited in other parts of the body, such as the
WHAT ARE arteries, kidneys, lungs, and brain. Calcium deposits can
cause problems with how these blood vessels and
CALCIFICATIONS
organs work.
(Intakes, 1997)
Merriam-Webster's Medical Dictionary. Calcification. www.merriam-
webster.com/medical. Accessed April 5th, 2023.
 Calcification can occur as a result of ageing, but it
can also be linked with infections, injuries, and
cancer. In addition, it can be dangerous for too
much calcium to build up in the arteries, kidneys,
or pericardium etc.

WHAT ARE
CALCIFICATIONS
 Calcification can occur as a result of ageing, but it
can also be linked with infections, injuries, and
cancer. In addition, it can be dangerous for too
much calcium to build up in the arteries, kidneys,
or pericardium etc.
RADIOGRAPHIC
APPEARANCE OF
CALCIFICATIONS
 Intracranial calcifications refer to calcifications within the
brain parenchyma or vasculature.
• Prevalence ranges from
o 1% in young individuals to
o up to 20% in elderly.

INTRACRANIAL (Saade et al., 2019)

CALCIFICATIONS
 INTRACRANIAL CALCIFICATIONS

Brain calcifications are a common radiographic finding.

The pathogenesis is diverse and ranges from benign
physiological calcifications to a variety of pathological
disorders. Whereas certain calcifications are
considered an incidental finding, their presence can
sometimes be crucial in making a specific diagnosis.
(Grech et al., 2012)
 INTRACRANIAL
CALCIFICATIONS
• The two most encountered
types of calcification include:

• Normal age-related IC
calcifications

• Intracranial arterial
atherosclerosis

However, concerning
calcifications are much less
common and occur in a variety of
settings, including;
Gaillard F, Knipe H, Thurston M, et al. Multiple intracranial calcifications. Reference article,
Radiopaedia.org (Accessed on 05 Apr 2023) https://doi.org/10.53347/rID-8211

(Saade et al., 2019)

 These can be defined as all age-related physiologic
and neurodegenerative calcifications. that are
unaccompanied by any evidence of disease and have
no demonstrable pathological cause. The most
common sites include:
• Pineal gland*
• Habenula
• Choroid plexus
• Basal ganglia
• Falx, dura or tentorium cerlbelli
• Wall of superior sagittal sinus,
• Temporal lobes.
It is important to identify these physiological calcifications
NORMAL so as to not falsely call them as pathology, e.g.,
IC CALCIFICATIONS hemorrhage.
* Most frequently, calcification of the pineal gland is noted,
incidence of which is noted as the age increases
 In these cases, it is also important to exclude normal calcifications.
Infection
• Neurocysticercosis
• Cerebral toxoplasmosis
• TORCH infection
Metabolic
• Hypoparathyroidism
• Pseudohypoparathyroidism
• Fahr disease
Previous cerebral insult
• Healed
CONCERNING oCerebral abscess
CALCIFICATIONS
oInfarct
oHematoma
 In these cases, it is also important to exclude normal calcifications.
Vascular malformation
• Cerebral AVM
• Sturge-weber syndrome
• Von hippel-lindau syndrome
Radiation
• Mineralization microangiopathy
Neurodegeneration
• Adult-onset leukoencephalopathy with axonal
spheroids and pigmented glia (ALPS)
• Urbach-wiethe disease
Neoplasms
• Craniophryngioma
CONCERNING • Astrocytoma
CALCIFICATIONS • Oligodendrogiloma
• Pinealoma
 • Intracranial calcifications can be detected on
skull x-rays, but other imaging modalities such
as computed tomography (CT) or magnetic
resonance imaging (MRI) are more sensitive
and specific for identifying and characterizing
these calcifications. The presence of
intracranial calcifications on imaging studies
can provide important diagnostic clues for the
RADIOLOGICAL underlying condition, and further investigation
DIAGNOSIS OF and management may be necessary depending
INTRACRANIAL on the specific clinical context.
CALCIFICATIONS (Taborda et al., 2017)
 When this occurs, it can be visualized on
skull x-ray as series of small, bright white
spots or patches.

RADIOLOGICAL
DIAGNOSIS OF
INTRACRANIAL
CALCIFICATIONS
Physiologic intracranial
calcifications.
From anterior to posterior:
• 1 c-shaped habenula,
• 2 pineal gland, and
• 3 the two superimposed choroid
plexuses are seen projecting
just above the ear.
Skull radiograph shows calcification of the falx cerebri (arrow) (Huang et al., 2010)
Radiograph shows a calcified tumor of choroid plexus
(arrows) in a 27-year-old woman. (Mayer and Wolcott, 1928)
Skull x-ray showing discrete intracranial calcifications
Brain calcinosis in a dialysis patient with hypoparathyroidism (Gionanlis et al., 2008)
IC
CALCIFICATIONS
PLAIN LATERAL RADIOGRAPH OF
THE SKULL DEMONSTRATES THE
TYPICAL TRAM-TRACK
CALCIFICATIONS (ARROW) IN
THE OCCIPITAL REGION
(STURGE-WEBER SYNDROME).
Craniopharyngioma.
Lateral (A) and frontal (B) radiograph of the skull
demonstrate a calcified mass (arrows) occupying an
enlarge sella turcica and extending upwards into the
suprasellar cistern. This represented local recurrence
of a craniopharyngioma surgically treated years
before.
THANK YOU