Abstract
Background: Unilateral basal ganglia calcinosis (BGC) is a rare radiological
finding that can be diagnosed on computed tomography (CT) and magnetic resonance
imaging (MRI) but often presents challenges for clinicians and radiologists in determining
its underlying cause. So far, only a few potential causes that could explain unilateral BGC
have been described in the literature. Case Report: A 54-year-old Caucasian male was
admitted to a tertiary university hospital due to the sudden onset of speech impairment
and right-sided weakness. The patient had no significant medical history prior to this
event. Non-enhanced computed tomography (NECT) of the brain revealed no evidence of
acute ischemia; CT angiography (CTA) showed acute left middle cerebral artery (MCA)
M2 segment occlusion. CT perfusion (CTP) maps revealed an extensive penumbra-like
lesion, which is potentially reversible upon achieving successful recanalization. However,
a primary neoplastic tumor with calcifications in the basal ganglia was initially interpreted
as the potential cause; therefore, acute stroke treatment with intravenous thrombolysis
was contraindicated. A follow-up CT examination at 24 h revealed an ischemic lesion
localized to the left insula, predominantly involving the left parietal lobe and the superior
gyrus of the left temporal lobe. Subsequent gadolinium-enhanced brain MRI revealed
small blood vessels draining into the subependymal periventricular veins on the left basal
ganglia. Digital subtraction angiography was conducted, confirming the diagnosis of
venous angioma. Conclusions: Unilateral BGC caused by venous angioma is a rare entity
with unclear pathophysiological mechanisms and heterogeneous clinical presentation. It
may mimic conditions such as intracerebral hemorrhage or hemorrhagic brain tumors,
complicating acute stroke management, as demonstrated in this case. Surrounding tissue
calcification may provide a valuable radiological clue in diagnosing venous angiomas
DVAs and vascular malformations.
finding that can be diagnosed on computed tomography (CT) and magnetic resonance
imaging (MRI) but often presents challenges for clinicians and radiologists in determining
its underlying cause. So far, only a few potential causes that could explain unilateral BGC
have been described in the literature. Case Report: A 54-year-old Caucasian male was
admitted to a tertiary university hospital due to the sudden onset of speech impairment
and right-sided weakness. The patient had no significant medical history prior to this
event. Non-enhanced computed tomography (NECT) of the brain revealed no evidence of
acute ischemia; CT angiography (CTA) showed acute left middle cerebral artery (MCA)
M2 segment occlusion. CT perfusion (CTP) maps revealed an extensive penumbra-like
lesion, which is potentially reversible upon achieving successful recanalization. However,
a primary neoplastic tumor with calcifications in the basal ganglia was initially interpreted
as the potential cause; therefore, acute stroke treatment with intravenous thrombolysis
was contraindicated. A follow-up CT examination at 24 h revealed an ischemic lesion
localized to the left insula, predominantly involving the left parietal lobe and the superior
gyrus of the left temporal lobe. Subsequent gadolinium-enhanced brain MRI revealed
small blood vessels draining into the subependymal periventricular veins on the left basal
ganglia. Digital subtraction angiography was conducted, confirming the diagnosis of
venous angioma. Conclusions: Unilateral BGC caused by venous angioma is a rare entity
with unclear pathophysiological mechanisms and heterogeneous clinical presentation. It
may mimic conditions such as intracerebral hemorrhage or hemorrhagic brain tumors,
complicating acute stroke management, as demonstrated in this case. Surrounding tissue
calcification may provide a valuable radiological clue in diagnosing venous angiomas
DVAs and vascular malformations.
Original language | English |
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Article number | 291 |
Number of pages | 11 |
Journal | Diagnostics |
Volume | 15 |
Issue number | 3 |
DOIs | |
Publication status | Published - 26 Jan 2025 |
Keywords*
- unilateral basal ganglia calcinosis
- venous angioma
- developmental venous anomalies
- complicated stroke management
- neuroradiology
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 1.4. Reviewed scientific article published in Latvia or abroad in a scientific journal with an editorial board (including university editions)