====== Multiple intracranial calcifications ======

1. common

a) choroid plexus: the most common site for physiologic calcification(in lateral ventricles where it is usually bilateral and symmetric; rare in 3rd & 4th ventricles). Increases in frequency and extent with age (prevalence: 75% by 5th decade). Rare under age 3. Underage 10, consider possible choroid plexus papilloma.  

b)
[[basal ganglia]] (BG): slight bilateral BG calcifications on CT are common, especially in the elderly. Considered a normal radiographic variant by some. They may be idiopathic, secondary to conditions such as hypoparathyroidism or long-term anticonvulsant use, or part of rare conditions such as Fahr’s disease. BG calcifications > 0.5 cm dia are possibly associated with cognitive impairment and a high prevalence of psychiatric symptoms (including bipolar and [[obsessive-compulsive disorder]]s, but no patients had schizophreniform disorders)

2. uncommon

a) Fahr’s disease: progressive idiopathic calcification of medial portions of basal ganglia, sulcal
depths of the cerebral cortex, and dentate nuclei

b) hemangioma, AVM, Sturge-Weber syndrome, von Hippel-Lindau disease

c) basal cell nevus syndrome (falx, tentorium)

d) Gorlin’s syndrome.Associated findings: mandibular cysts, rib, and vertebral deformities, short
metacarpals. Medulloblastoma is seen in several patients

e) deposition of calcium in the media of medium-sized blood vessels without compromise of the lumen. Usually asymptomatic. May become symptomatic by the time the involvement is significant enough to be visible on plain X-ray in a young person

f) cytomegalic inclusion disease

g) encephalitis(e.g.measles,chickenpox,neonatal herpes simplex)

h) hematomas(SDHorEDH,chronic)

i) neurofibromatosis (choroid plexus)

j) toxoplasmosis

k) tuberculomas;tuberculous meningitis(treated)

l) tuberous sclerosis

m) hypoparathyroidism (including post-thyroidectomy cases35) and pseudohypoparathyroidism

n) multiple tumors(e.g.meningiomas, gliomas, metastases)

o) cysticercosis cyst: maybe single or multiple, see [[Neurocysticercosis]](p.386)

In adult patients with suspicison incipient supratentorial grade II/III [[diffuse glioma]]s, presence of calcifications and larger preoperative tumor volume might be used as preoperative indices to differentiate between malignancy grades II and III in oligodendrogliomas (IDH-mutant and 1p/19q-codeleted) and larger preoperative tumor volume might have similar utility in IDH-mutant astrocytomas
((Fukuya Y, Tamura M, Nitta M, Saito T, Tsuzuki S, Koriyama S, Kuwano A, Kawamata T, Muragaki Y. Tumor volume and calcifications as indicators for preoperative differentiation of grade II/III diffuse gliomas. J Neurooncol. 2023 Feb 7. doi: 10.1007/s11060-023-04244-3. Epub ahead of print. PMID: 36749444.)).

Ji C, Ahn JG. [[Multiple intracranial calcifications]] as a complication of
external ventricular drain placement. J Korean Neurosurg Soc. 2010
Feb;47(2):158-60. doi: 10.3340/jkns.2010.47.2.158. Epub 2010 Feb 28. PubMed PMID:
20224720; PubMed Central PMCID: PMC2836456.