Brain stones, also known as cerebral calculi, refer to sizable intracranial calcifications that may be solitary or multiple.
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Terminology
The term is nonspecific and infrequently used, and it has the potential to be misunderstood as a diagnosis rather than as a descriptive term. To make matters worse, reviews of the term seem to list any cause of calcification as a possible cause, which further reduces its utility 1-4.
Clinical presentation
Most patients will be asymptomatic. If symptomatic, patients most commonly present with seizures.
Pathology
Localization of brain stones can help narrow the underlying etiology but the causes are numerous 1:
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intra-axial
calcifying tumors, e.g. oligodendrogliomas
vascular, e.g. cavernous malformations, arteriovenous malformations, aneurysms
infectious, e.g. congenital TORCH infections, tuberculosis, neurocysticercosis
congenital, e.g. Sturge-Weber syndrome, tuberous sclerosis, intracranial lipomas
metabolic, e.g. Fahr disease, hyper/hypoparathyroidism, pseudohypoparathyroidism
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extra-axial
calcifying tumors, e.g. adamantinomatous craniopharyngiomas
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intra- or extra-axial
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