Histology and computed tomography of incidental calcifications in the human basal ganglia

Esther J M De Brouwer,Annemarieke De Jonghe,Jan-Willem Dankbaar,Huiberdina L Koek,Wim Van Hecke,Firdaus A A Mohamed Hoesein,Marielle H Emmelot-Vonk,Pim A De Jong

doi:10.1007/s00234-021-02680-4

Esther J M De Brouwer, Annemarieke De Jonghe + Show 6 more

Open Access

https://doi.org/10.1007/s00234-021-02680-4

Copy DOI

Journal: Neuroradiology	Publication Date: Mar 20, 2021
Citations: 3	License type: open-access

Affiliation: Tergooi, University Medical Center Utrecht

Abstract

Incidental basal ganglia calcifications are a common finding on computed tomography (CT). We investigated the histological characteristics of these calcifications and their association with CT findings, using post-mortem basal ganglia tissue from 22 patients. Eight patients had basal ganglia calcifications on histology, and six patients had calcifications on CT, varying from mild to severe. Four patients had calcifications identified by both histology and CT, and two patients had calcifications detected by CT but not by histology, possibly because of insufficient tissue available. Calcifications were found mainly in the tunica media of arterioles located in the globus pallidus, which suggests that incidental CT calcifications are vascular in nature. However, tunica media calcifications, and thereby incidental basal ganglia calcifications, are probably not related to atherosclerosis.

Highlights

The first radiological description of basal ganglia calcifications dates from 1924 [1]
Calcifications in the basal ganglia are most often detected incidentally during computed tomography (CT) scanning of the brain and have a prevalence of 0.32–38% [2,3,4]. These calcifications are usually considered innocent, they may be associated with diabetes and psychotic symptoms [4, 5]
There is one neuropathological study describing the histological nature of incidental basal ganglia calcifications in patients who did not have Fahr disease but who had a neurodegenerative disease, such as Alzheimer’s disease, frontotemporal dementia, progressive supranuclear palsy, or Parkinson’s disease [9]

Summary

Introduction

The first radiological description of basal ganglia calcifications dates from 1924 [1]. Calcifications in the basal ganglia are most often detected incidentally during computed tomography (CT) scanning of the brain and have a prevalence of 0.32–38% [2,3,4]. These calcifications are usually considered innocent, they may be associated with diabetes and psychotic symptoms [4, 5]. Patients with Fahr disease, who have severe basal ganglia calcification, suffer from movement disorders, cognitive disorders, and psychiatric symptoms [6]. Calcifications in the internal elastic lamina and tunica media are usually nonatherosclerotic in origin, in contrast to calcifications of the tunica intima, and are associated with diabetes mellitus and chronic kidney disease [10]

Methods

Results

Conclusion