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Journal of Neurocritical Care > Volume 7(2); 2014 > Article
Kim, Choi, Lee, and Jeon: Brain Calcification Associated with Pseudohypoparathyroidism
A 23-year-old, previously healthy woman presented with a first-onset generalized tonic-clonic seizure. Neurological examination was unremarkable. Computed tomography of the brain showed extensive symmetric calcifications in the corticomedullary junctions, basal ganglia, thalami, and cerebellar hemispheres (Fig. 1). Serum laboratory studies revealed levels of calcium 5.7 mg/dL (8.6-10.2 mg/dL), phosphorus 4.4 mg/dL (3.5-4.5 mg/dL), and parathyroid hormone 151 pg/mL (10-65 pg/mL) consistent with pseudohypoparathyroidism. Her clinical features of a round face, short stature, and short fourth and fifth metacarpals suggested pseudohypoparathyroidism type Ia, Albright’s hereditary osteodystrophy [1]. Pseudohypoparathyroidism is one of medical conditions which can be accompanied by brain calcifications, especially strio-pallido-dentate calcinosis [2].

Figure 1.
Brain CT demonstrates extensive symmetric calcifications in corticomedullary junctions (A), basal ganglia and thalami (B), and cerebellar hemispheres (C). Calcifications of the brain are also seen in a cranial radiograph (D). Arrows indicate calcifications.
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REFERENCES

1. Al-Azem H, Khan AA. Hypoparathyroidism. Best Pract Res Clin Endocrinol Metab 2012; 26: 517-22.
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2. Bonazza S, La Morgia C, Martinelli P, Capellari S. Strio-pallidodentate calcinosis: a diagnostic approach in adult patients. Neurol Sci 2011; 32: 537-45.
crossref pmid
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