There are many causes of basal ganglia T1 hyperintensity, but the majority relate to deposition of T1-shortening elements within the basal ganglia such as:
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calcium
idiopathic calcification
calcium and phosphate abnormalities
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hepatic dysfunction or bypass (specifically affecting globi pallidi)
hereditary haemorrhagic telangiectasia, often with hepatic arteriovenous malformations 5
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toxins/ischaemia
carbon monoxide (usually low T1 signal; unless associated with haemorrhage)
kratom 6
previous administration of linear gadolinium chelates 3,4
global hypoxia
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blood
methaemoglobin in intracranial haemorrhage
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others
hamartoma in neurofibromatosis type 1
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