Journal of Pediatric Neuroradiology 2015; 04(03): 049-059
DOI: 10.1055/s-0036-1583312
Review Article
Georg Thieme Verlag KG Stuttgart • New York

Intracranial Calcifications in the Pediatric Age Group: An Imaging Review

Anthony M. Dinizio
1   Department of Radiology, University of Vermont Medical Center, Burlington, Vermont, United States
,
Jonathan K. Vincent
2   Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, United States
,
Joshua P. Nickerson
1   Department of Radiology, University of Vermont Medical Center, Burlington, Vermont, United States
› Author Affiliations
Further Information

Publication History

21 January 2015

23 February 2016

Publication Date:
04 May 2016 (online)

Abstract

Intracranial calcifications in the pediatric population are frequently encountered on imaging studies and may be seen in association with a variety of disease states. This review article provides an overview of the various pathological entities which may result in calcification on pediatric neuroimaging studies, including their key clinical, imaging, and histological features. For ease of discussion, disease categories are grouped into neoplastic, infectious, vascular, iatrogenic, and metabolic etiologies. The phakomatoses are discussed as well. It is hoped that the information contained in this review will assist the reader in formulating an appropriate differential diagnosis when intracranial calcifications are identified on imaging examinations.

 
  • References

  • 1 Borden NM. Pattern Recognition Neuroradiology. New York, NY: Cambridge University Press; 2011
  • 2 Barkovich AJ. Pediatric Neuroimaging. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005
  • 3 Tice H, Barnes PD, Goumnerova L, Scott RM, Tarbell NJ. Pediatric and adolescent oligodendrogliomas. AJNR Am J Neuroradiol 1993; 14 (6) 1293-1300
  • 4 Borja MJ, Plaza MJ, Altman N, Saigal G. Conventional and advanced MRI features of pediatric intracranial tumors: supratentorial tumors. AJR Am J Roentgenol 2013; 200 (5) W483-503
  • 5 Koeller KK, Henry JM ; Armed Forces Institute of Pathology. From the archives of the AFIP: superficial gliomas: radiologic-pathologic correlation. Radiographics 2001; 21 (6) 1533-1556
  • 6 Zentner J, Wolf HK, Ostertun B , et al. Gangliogliomas: clinical, radiological, and histopathological findings in 51 patients. J Neurol Neurosurg Psychiatry 1994; 57 (12) 1497-1502
  • 7 Daghistani R, Miller E, Kulkarni AV, Widjaja E. Atypical characteristics and behavior of dysembryoplastic neuroepithelial tumors. Neuroradiology 2013; 55 (2) 217-224
  • 8 Crespo-Rodríguez AM, Smirniotopoulos JG, Rushing EJMR. MR and CT imaging of 24 pleomorphic xanthoastrocytomas (PXA) and a review of the literature. Neuroradiology 2007; 49 (4) 307-315
  • 9 Arivazhagan A, Devi BI, Kolluri SV, Abraham RG, Sampath S, Chandramouli BA. Pediatric intracranial meningiomas—do they differ from their counterparts in adults?. Pediatr Neurosurg 2008; 44 (1) 43-48
  • 10 Koeller KK, Sandberg GD ; Armed Forces Institute of Pathology. From the archives of the AFIP. Cerebral intraventricular neoplasms: radiologic-pathologic correlation. Radiographics 2002; 22 (6) 1473-1505
  • 11 Wang M, Jia D, Shen J, Zhang J, Li G. Clinical and imaging features of central neurocytomas. J Clin Neurosci 2013; 20 (5) 679-685
  • 12 Poretti A, Meoded A, Huisman TA. Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging 2012; 35 (1) 32-47
  • 13 Lee YY, Van Tassel P, Bruner JM, Moser RP, Share JC. Juvenile pilocytic astrocytomas: CT and MR characteristics. AJR Am J Roentgenol 1989; 152 (6) 1263-1270
  • 14 Chang T, Teng MM, Lirng JF. Posterior cranial fossa tumours in childhood. Neuroradiology 1993; 35 (4) 274-278
  • 15 Koeller KK, Rushing EJ. From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics 2003; 23 (6) 1613-1637
  • 16 Parmar H, Hawkins C, Bouffet E, Rutka J, Shroff M. Imaging findings in primary intracranial atypical teratoid/rhabdoid tumors. Pediatr Radiol 2006; 36 (2) 126-132
  • 17 Schroeder JW, Vezina LG. Pediatric sellar and suprasellar lesions. Pediatr Radiol 2011; 41 (3) 287-298 , quiz 404–405
  • 18 Jaing TH, Wang HS, Hung IJ , et al. Intracranial germ cell tumors: a retrospective study of 44 children. Pediatr Neurol 2002; 26 (5) 369-373
  • 19 Gaillard F, Jones J. Masses of the pineal region: clinical presentation and radiographic features. Postgrad Med J 2010; 86 (1020) 597-607
  • 20 Nickerson JP, Richner B, Santy K , et al. Neuroimaging of pediatric intracranial infection—part 1: techniques and bacterial infections. J Neuroimaging 2012; 22 (2) e42-e51
  • 21 Lago EG, Baldisserotto M, Hoefel Filho JR, Santiago D, Jungblut R. Agreement between ultrasonography and computed tomography in detecting intracranial calcifications in congenital toxoplasmosis. Clin Radiol 2007; 62 (10) 1004-1011
  • 22 Nickerson JP, Richner B, Santy K , et al. Neuroimaging of pediatric intracranial infection—part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging 2012; 22 (2) e52-e63
  • 23 Fink KR, Thapa MM, Ishak GE, Pruthi S. Neuroimaging of pediatric central nervous system cytomegalovirus infection. Radiographics 2010; 30 (7) 1779-1796
  • 24 Foerster BR, Thurnher MM, Malani PN, Petrou M, Carets-Zumelzu F, Sundgren PC. Intracranial infections: clinical and imaging characteristics. Acta Radiol 2007; 48 (8) 875-893
  • 25 Tien RD, Felsberg GJ, Osumi AK. Herpesvirus infections of the CNS: MR findings. AJR Am J Roentgenol 1993; 161 (1) 167-176
  • 26 Dimova PS, Karparov AA. Congenital varicella syndrome: case with isolated brain damage. J Child Neurol 2001; 16 (8) 595-597
  • 27 O'Brien K, Leach J, Jones B, Bissler J, Zuccarello M, Abruzzo T. Calcifications associated with pediatric intracranial arterial aneurysms: incidence and correlation with pathogenetic subtypes. Childs Nerv Syst 2013; 29 (4) 643-649
  • 28 Bhatia S, Sekula RF, Quigley MR, Williams R, Ku A. Role of calcification in the outcomes of treated, unruptured, intracerebral aneurysms. Acta Neurochir (Wien) 2011; 153 (4) 905-911
  • 29 Jordan LC, Johnston SC, Wu YW, Sidney S, Fullerton HJ. The importance of cerebral aneurysms in childhood hemorrhagic stroke: a population-based study. Stroke 2009; 40 (2) 400-405
  • 30 Packer RJ, Meadows AT, Rorke LB, Goldwein JL, D'Angio G. Long-term sequelae of cancer treatment on the central nervous system in childhood. Med Pediatr Oncol 1987; 15 (5) 241-253
  • 31 Bekiesinska-Figatowska M, Mierzewska H, Jurkiewicz E. Basal ganglia lesions in children and adults. Eur J Radiol 2013; 82 (5) 837-849
  • 32 Fernández-Bouzas A, Ramirez Jiménez H, Vázquez Zamudio J, Alonso-Vanegas M, Mendizabal Guerra R. Brain calcifications and dementia in children treated with radiotherapy and intrathecal methotrexate. J Neurosurg Sci 1992; 36 (4) 211-214
  • 33 Taha MM. Armored brain in patients with hydrocephalus after shunt surgery: review of the literatures. Turk Neurosurg 2012; 22 (4) 407-410
  • 34 de Oliveira Sillero R, Zanini MA, Gabarra RC. Large chronic epidural hematoma with calcification: a case report. J Trauma 2008; 64 (6) 1619-1621 , discussion 1621
  • 35 Salunke P, Aggarwal A, Madhivanan K, Futane S. Armoured brain due to chronic subdural collections masking underlying hydrocephalus. Br J Neurosurg 2013; 27 (4) 524-525
  • 36 Erdogan B, Sen O, Bal N, Cekinmez M, Altinors N. Rapidly calcifying and ossifying epidural hematoma. Pediatr Neurosurg 2003; 39 (4) 208-211
  • 37 Chang JH, Choi JY, Chang JW, Park YG, Kim TS, Chung SS. Chronic epidural hematoma with rapid ossification. Childs Nerv Syst 2002; 18 (12) 712-716
  • 38 Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012. . Available online at: http://accessmedicine.mhmedical.com
  • 39 Deepak S, Jayakumar B , Shanavas. Extensive intracranial calcification. J Assoc Physicians India 2005; 53: 948
  • 40 Fujita T. Mechanism of intracerebral calcification in hypoparathyroidism. Clin Calcium 2004; 14 (6) 55-57
  • 41 Mejdoubi M, Zegermann T. Neurological picture. Extensive brain calcification in idiopathic hypoparathyroidism. J Neurol Neurosurg Psychiatry 2006; 77 (12) 1328
  • 42 Seyahi N, Apaydin S, Sariyar M, Serdengecti K, Erek E. Intracranial calcification and tumoural calcinosis during vitamin D therapy. Nephrology (Carlton) 2004; 9 (2) 89-93
  • 43 Arii J, Tanabe Y, Makino M, Sato H, Kohno Y. Children with irreversible brain damage associated with hypothyroidism and multiple intracranial calcifications. J Child Neurol 2002; 17 (4) 309-313
  • 44 Abduljabbar MA, Afifi AM. Congenital hypothyroidism. J Pediatr Endocrinol Metab 2012; 25 (1–2) 13-29
  • 45 Lin DD, Barker PB. Neuroimaging of phakomatoses. Semin Pediatr Neurol 2006; 13 (1) 48-62
  • 46 Martí-Bonmatí L, Menor F, Poyatos C, Cortina H. Diagnosis of Sturge-Weber syndrome: comparison of the efficacy of CT and MR imaging in 14 cases. AJR Am J Roentgenol 1992; 158 (4) 867-871