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### Selected Images
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**Aging Brain, Normal**
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*Axial NECT shows typical basal ganglia (BG) Ca⁺⁺ in this 75-year-old man who presented after minor trauma. Note the location within the globus pallidus (GP) <img src='/img/arrows/CS.png'/>, typical for normal aging brain. Physiologic Ca⁺⁺ is typically seen in adults over 30 years.*
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*Axial NECT shows typical basal ganglia (BG) Ca⁺⁺ in this 75-year-old man who presented after minor trauma. Note the location within the globus pallidus (GP) <img src='img/arrows/CS.png'/>, typical for normal aging brain. Physiologic Ca⁺⁺ is typically seen in adults over 30 years.*
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**Aging Brain, Normal**
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*Axial NECT shows typical basal ganglia (BG) Ca⁺⁺ in this 75-year-old man who presented after minor trauma. Note the location within the globus pallidus (GP) <img src='/img/arrows/CS.png'/>, typical for normal aging brain. Physiologic Ca⁺⁺ is typically seen in adults over 30 years.*
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*Axial NECT shows typical basal ganglia (BG) Ca⁺⁺ in this 75-year-old man who presented after minor trauma. Note the location within the globus pallidus (GP) <img src='img/arrows/CS.png'/>, typical for normal aging brain. Physiologic Ca⁺⁺ is typically seen in adults over 30 years.*
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**Neurocysticercosis**
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*Axial CT shows multiple calcified nodules in the deep gray nuclei <img src='/img/arrows/CS.png'/> & along the cortex related to the nodular, calcified (healed) stage of neurocysticercosis. This intracranial parasitic infection is caused by the pork tapeworm Taenia solium.*
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*Axial CT shows multiple calcified nodules in the deep gray nuclei <img src='img/arrows/CS.png'/> & along the cortex related to the nodular, calcified (healed) stage of neurocysticercosis. This intracranial parasitic infection is caused by the pork tapeworm Taenia solium.*
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**Fahr Disease**
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*Axial NECT shows the typical CT appearance of Fahr disease (FD) with extensive calcifications present in the BG, cerebral white matter (WM), & at the subcortical gray matter-WM junctions.*
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**Hypoxic-Ischemic Injury**
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*Axial NECT shows calcification of thalami & BG <img src='/img/arrows/WC.png'/> from status marmoratus. There is atrophy & a collapsed calvarium following remote mixed hypoxic-ischemic injury (HII) in this infant. Profound acute HII typically affects the BG.*
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*Axial NECT shows calcification of thalami & BG <img src='img/arrows/WC.png'/> from status marmoratus. There is atrophy & a collapsed calvarium following remote mixed hypoxic-ischemic injury (HII) in this infant. Profound acute HII typically affects the BG.*
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**Mitochondrial Disorders**
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*Axial NECT in a teenager shows bilateral GP <img src='/img/arrows/WS.png'/> Ca⁺⁺, a rare finding in patients < 30 years.*
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*Axial NECT in a teenager shows bilateral GP <img src='img/arrows/WS.png'/> Ca⁺⁺, a rare finding in patients < 30 years.*
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**Mitochondrial Disorders**
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*FLAIR MR (same patient) shows left frontal & parietal hyperintensity related to recent middle cerebral artery <img src='/img/arrows/CS.png'/> & anterior cerebral artery <img src='/img/arrows/CO.png'/> infarcts. Muscle biopsy showed myoclonic epilepsy with ragged-red fibers. This rare mitochondrial disorder often presents with myoclonus & seizures. Imaging mimics other mitochondrial disorders, incl. mitochondrial myopathy, encephalopathy, lactic acidosis, & stroke-like episodes (MELAS).*
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*FLAIR MR (same patient) shows left frontal & parietal hyperintensity related to recent middle cerebral artery <img src='img/arrows/CS.png'/> & anterior cerebral artery <img src='img/arrows/CO.png'/> infarcts. Muscle biopsy showed myoclonic epilepsy with ragged-red fibers. This rare mitochondrial disorder often presents with myoclonus & seizures. Imaging mimics other mitochondrial disorders, incl. mitochondrial myopathy, encephalopathy, lactic acidosis, & stroke-like episodes (MELAS).*
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**Mitochondrial Disorders**
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*Axial NECT shows Ca⁺⁺ of the GP bilaterally <img src='/img/arrows/WS.png'/> in this child with MELAS. Note the low density in the medial occipital lobes related to <img src='/img/arrows/CO.png'/> infarcts. BG Ca⁺⁺ is abnormal in children & young adults.*
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*Axial NECT shows Ca⁺⁺ of the GP bilaterally <img src='img/arrows/WS.png'/> in this child with MELAS. Note the low density in the medial occipital lobes related to <img src='img/arrows/CO.png'/> infarcts. BG Ca⁺⁺ is abnormal in children & young adults.*
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**HIV, Congenital**
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*Axial NECT in a patient with congenital HIV shows bilateral symmetrical BG Ca⁺⁺ predominantly in the GP <img src='/img/arrows/CS.png'/>. This Ca⁺⁺ is seen typically months after birth. With HIV, involvement of the lentiform nuclei Ca⁺⁺ is greater than the caudate heads.*
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*Axial NECT in a patient with congenital HIV shows bilateral symmetrical BG Ca⁺⁺ predominantly in the GP <img src='img/arrows/CS.png'/>. This Ca⁺⁺ is seen typically months after birth. With HIV, involvement of the lentiform nuclei Ca⁺⁺ is greater than the caudate heads.*
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**CMV, Congenital**
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**Endocrinologic Disorders**
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*Axial NECT in a patient with pseudohypoparathyroidism shows dense Ca⁺⁺ within the BG & subcortical WM in a pseudohypoparathyroidism patient. There is significant imaging overlap between systemic diseases with abnormal calcium deposition.*
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**Toxoplasmosis, Acquired**
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*Axial T1 C+ MR shows an enhancing right BG mass <img src='/img/arrows/CS.png'/> in an AIDS patient. Post therapy, enhancing lesions typically calcify. The BG is the most common location for toxoplasmosis followed by the thalamus, then the cerebral hemispheres.*
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*Axial T1 C+ MR shows an enhancing right BG mass <img src='img/arrows/CS.png'/> in an AIDS patient. Post therapy, enhancing lesions typically calcify. The BG is the most common location for toxoplasmosis followed by the thalamus, then the cerebral hemispheres.*
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**Leigh Syndrome**
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*Axial T2WI MR shows symmetric T2 hyperintensity in the BG <img src='/img/arrows/BS.png'/> bilaterally in this child with neurodegeneration. Ca⁺⁺ of the BG is seen in chronic cases.*
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*Axial T2WI MR shows symmetric T2 hyperintensity in the BG <img src='img/arrows/BS.png'/> bilaterally in this child with neurodegeneration. Ca⁺⁺ of the BG is seen in chronic cases.*
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**Radiation & Chemotherapy**
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*Axial NECT shows mineralizing microangiopathy related to radiation therapy & chemotherapy for a remote childhood neoplasm. Note the symmetric Ca⁺⁺ in the BG & subcortical WM. This typically occurs ~ 2 years after therapy with XRT & chemotherapy.*
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**Tuberous Sclerosis Complex (Mimic)**
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*Axial T2 MR shows calcified subependymal nodules in the foramen of Monro region <img src='/img/arrows/CS.png'/> in this child with seizures, mimicking BG Ca⁺⁺. These nodules occur in 98% of patients with tuberous sclerosis.*
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*Axial T2 MR shows calcified subependymal nodules in the foramen of Monro region <img src='img/arrows/CS.png'/> in this child with seizures, mimicking BG Ca⁺⁺. These nodules occur in 98% of patients with tuberous sclerosis.*
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**Developmental Venous Anomaly**
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*Axial NECT shows dense Ca⁺⁺ in right BG <img src='/img/arrows/CS.png'/> & thalamus. CE images (not shown) revealed an underlying developmental venous anomaly. These are congenital cerebral vascular malformations with mature venous elements, which may rarely have Ca⁺⁺ possibly related to underlying venous congestion & ischemia.*
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*Axial NECT shows dense Ca⁺⁺ in right BG <img src='img/arrows/CS.png'/> & thalamus. CE images (not shown) revealed an underlying developmental venous anomaly. These are congenital cerebral vascular malformations with mature venous elements, which may rarely have Ca⁺⁺ possibly related to underlying venous congestion & ischemia.*
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### Additional Images
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**Fahr Disease**
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*Axial NECT shows a variant CT appearance of FD with extensive Ca⁺⁺ present in the BG, cerebral WM, & at the subcortical gray matter-WM junctions.*
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**Pantothenate Kinase-Associated Neurodegeneration**
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*Axial NECT shows globus pallidus mineralization bilaterally <img src='/img/arrows/CS.png'/> in a patient with pantothenate kinase-associated neurodegeneration. CT is typically normal. T2 MR shows classic the eye of the tiger appearance with globus pallidus hypointensity related to iron accumulation with medial T2 hyperintensity.*
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*Axial NECT shows globus pallidus mineralization bilaterally <img src='img/arrows/CS.png'/> in a patient with pantothenate kinase-associated neurodegeneration. CT is typically normal. T2 MR shows classic the eye of the tiger appearance with globus pallidus hypointensity related to iron accumulation with medial T2 hyperintensity.*
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**CMV, Congenital**
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**CMV, Congenital**
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*Axial NECT shows periventricular & BG Ca⁺⁺. Periventricular calcifications, ventriculomegaly, & microcephaly strongly suggest congenital CMV infection.*
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**Toxoplasmosis, Acquired**
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*Axial CECT shows an enhancing BG mass <img src='/img/arrows/WS.png'/> in an AIDS patient. Post therapy, enhancing lesions typically calcify. BG is the most common location followed by thalamus, then hemispheres.*
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*Axial CECT shows an enhancing BG mass <img src='img/arrows/WS.png'/> in an AIDS patient. Post therapy, enhancing lesions typically calcify. BG is the most common location followed by thalamus, then hemispheres.*
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**Vascular Calcification (Mimic)**
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*Axial NECT shows intracranial atherosclerotic disease with extensive Ca⁺⁺ in internal carotid & middle cerebral arteries <img src='/img/arrows/WS.png'/>, which mimics BG Ca⁺⁺. Posterior fossa aneurysm is partially visible.*
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*Axial NECT shows intracranial atherosclerotic disease with extensive Ca⁺⁺ in internal carotid & middle cerebral arteries <img src='img/arrows/WS.png'/>, which mimics BG Ca⁺⁺. Posterior fossa aneurysm is partially visible.*
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**Tuberous Sclerosis Complex (Mimic)**
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*Axial NECT shows calcified subependymal nodules in the foramen of Monro & periventricular regions, which mimic BG Ca⁺⁺. These typically accompany cortical tubers <img src='/img/arrows/WC.png'/>, better seen on MR.*
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*Axial NECT shows calcified subependymal nodules in the foramen of Monro & periventricular regions, which mimic BG Ca⁺⁺. These typically accompany cortical tubers <img src='img/arrows/WC.png'/>, better seen on MR.*
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**Parasites, Miscellaneous**
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*Axial CECT shows a case of paragonimiasis with a hyperdense left BG nodule <img src='/img/arrows/WS.png'/>. This parasite often presents with conglomerated granulomas, which may hemorrhage. Multiple Ca⁺⁺ are common.*
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*Axial CECT shows a case of paragonimiasis with a hyperdense left BG nodule <img src='img/arrows/WS.png'/>. This parasite often presents with conglomerated granulomas, which may hemorrhage. Multiple Ca⁺⁺ are common.*
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**Neurocysticercosis**
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*Axial CECT shows a calcified left putamen nodule <img src='/img/arrows/CS.png'/> that represents the nodular, calcified (healed) stage of neurocysticercosis. Note the right external capsule cyst with a central "dot" representing a scolex.*
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*Axial CECT shows a calcified left putamen nodule <img src='img/arrows/CS.png'/> that represents the nodular, calcified (healed) stage of neurocysticercosis. Note the right external capsule cyst with a central "dot" representing a scolex.*
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**Pseudohypoparathyroidism**
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