Brain Calcifications and Primary Hyperparathyroidism

Llamas, Roberto de la Plaza; Ángel, José Manuel Ramia; Peralta, Vladimir Arteaga; Cristóbal, J. Hernández; Marcano, Aylhín Joana López

doi:10.1016/j.cireng.2015.12.001

Cited by 3 publications

(12 citation statements)

References 7 publications

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“…Primary hyperparathyroidism is caused by parathyroid adenoma (75%-85%), parathyroid hyperplasia (10%-20%), or carcinoma (1%-5%) and is characterized by high serum levels of parathyroid hormone and calcium serum levels. Secondary hyperparathyroidism is related to chronic renal failure, in which the kidneys fail to convert vitamin D to the active form and excrete phosphate, leading to high parathyroid hormone levels, normal or low calcium levels, and high phosphate serum levels (2,27,28).…”

Section: Parathyroid-hypofunction Disorders and Hyperparathyroidism-rmentioning

confidence: 99%

“…In primary hyperparathyroidism, the salt-and-pepper appearance (ie, multiple well-defined hypointensities in the skull owing to trabecular bone resorption) can be observed, while in secondary hyperparathyroidism, diffuse thickening of the skull, plaquelike dural thickening, calcification, and pipestem calcifications of carotid arteries are found. Brown tumors can manifest in both types of hyperparathyroidism and are described as well-defined round lytic lesions without sclerotic margins or cortical involvement (27,28).…”

Section: Parathyroid-hypofunction Disorders and Hyperparathyroidism-rmentioning

confidence: 99%

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Imaging Patterns of Toxic and Metabolic Brain Disorders

Oliveira

Paulino

Vieira³

et al. 2019

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Toxic and metabolic brain disorders are relatively uncommon diseases that affect the central nervous system, but they are important to recognize as they can lead to catastrophic outcomes if not rapidly and properly managed. Imaging plays a key role in determining the most probable diagnosis, pointing to the next steps of investigation, and providing prognostic information. The majority of cases demonstrate bilateral and symmetric involvement of structures at imaging, affecting the deep gray nuclei, cortical gray matter, and/or periventricular white matter, and some cases show specific imaging manifestations. When an appropriate clinical situation suggests exogenous or endogenous toxic effects, the associated imaging pattern usually indicates a restricted group of diagnostic possibilities. Nonetheless, toxic and metabolic brain disorders in the literature are usually approached in the literature by starting with common causal agents and then reaching imaging abnormalities, frequently mixing many different possible manifestations. Conversely, this article proposes a systematic approach to address this group of diseases based on the most important imaging patterns encountered in clinical practice. Each pattern is suggestive of a most likely differential diagnosis, which more closely resembles real-world scenarios faced by radiologists. Basic pathophysiologic concepts regarding cerebral edemas and their relation to imaging are introduced-an important topic for overall understanding. The most important imaging patterns are presented, and the main differential diagnosis for each pattern is discussed.

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Section: Parathyroid-hypofunction Disorders and Hyperparathyroidism-rmentioning

confidence: 99%

Section: Parathyroid-hypofunction Disorders and Hyperparathyroidism-rmentioning

confidence: 99%

Imaging Patterns of Toxic and Metabolic Brain Disorders

Oliveira

Paulino

Vieira³

et al. 2019

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“…Initial diagnostic pathways may point towards more common causes such as hypoparathyroidism, pseudohypoparathyroidism and pseudo-pseudohypoparathyroidism 10. Other conditions such as renal failure, severe vitamin D deficiency and pancreatitis could also contribute to cranial calcifications.…”

Section: Discussionmentioning

confidence: 99%

“…Other conditions such as renal failure, severe vitamin D deficiency and pancreatitis could also contribute to cranial calcifications. With supportive laboratory investigations uneventful for ascertainment for the cause, further diagnostic pathways can be taken up 1 2 9 10…”

Section: Discussionmentioning

confidence: 99%

“…This could also be supported with clinical features and radiological evidence of the same within other family members as seen in our case, with evidence of family history showing an autosomal-dominant mode of inheritance. The absence of any other biochemical abnormalities suggestive of endocrinopathies, defects in calcium metabolism, infections, toxins or trauma is also required to diagnose FD 1 3 10…”

Section: Discussionmentioning

confidence: 99%

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Fahr’s disease in a patient with recurrent pneumonias, parkinsonism and dementia

Pinto,

Agrawal,

Schmidt

et al. 2024

BMJ Case Rep

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Fahr’s disease is a rare condition characterised by the presence of idiopathic familial bilateral basal ganglia calcifications, transmitted in an autosomal-dominant fashion. Diagnosis is based on clinical features of neuropsychiatric and somatic symptoms in conjunction with radiological findings. Our patient, a man in his early 50s, presented with pneumonia. History was significant for five admissions in the last 2 years for pneumonia and falls, with gradual cognitive and motor decline since his late 30s. Hypophonia, bradykinesia and dementia were noted on examination. CT of the brain revealed bilateral thalamic calcinosis, consistent with Fahr’s syndrome. Further investigations and retrospective history taking, and similar radiological findings within first-degree and second-degree relatives with early deaths, transitioned the diagnosis from Fahr’s syndrome to Fahr’s disease. We present this case of Fahr’s disease to emphasise the value of collaboration among multidisciplinary professionals to improve quality of care for such patients.

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Cerebral Calcifications as a Result of Primary Hyperparathyroidism: A Report of a Rare Case

Hyusein,

Atsev,

Boyukliev

et al. 2024

Cureus

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Primary hyperparathyroidism (PHPT) is an extremely uncommon cause of cerebral calcification. A male patient, aged 45, was admitted to the neurosurgery clinic with a closed traumatic brain injury, namely a concussion, resulting in symptoms of headache and loss of balance. A CT scan was conducted, which detected bilateral calcifications on the basal ganglia and the tentorium. The blood tests revealed increased levels of serum calcium, phosphate, and parathyroid hormone (PTH), while vitamin D levels were within the normal range. The patient received symptomatic therapy for the cerebral concussion and was referred for further diagnostic procedures. Based on these exams, it was determined that the patient had a parathyroid adenoma, which was responsible for PHPT characterised by increased levels of calcium, phosphate, and PTH. The patient subsequently underwent a successful parathyroidectomy. Half a year following the surgical procedure, the patient remained free of any indications of neurological conditions, and the levels of PTH and calcium in their body were within the expected range. Whenever trying to identify the cause of cerebral calcification, it is important to explore several possible diagnoses. A possible cause that should be taken into account is PHTP.

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Brain Calcifications and Primary Hyperparathyroidism

Cited by 3 publications

References 7 publications

Imaging Patterns of Toxic and Metabolic Brain Disorders

Imaging Patterns of Toxic and Metabolic Brain Disorders

Fahr’s disease in a patient with recurrent pneumonias, parkinsonism and dementia

Cerebral Calcifications as a Result of Primary Hyperparathyroidism: A Report of a Rare Case

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