Metastatic calcification in the brain
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Calcification is redemonstrated through the basal ganglia and extending into the white matter of the corona radiata as well as the cerebellar white matter. Review of previous reports reveals a history hypercalcemia making metastatic calcification the most likely aetiology. Appearances are stable when compared to the previous examination.
Focal hypodensity involving both the cortex and underlying white matter of the parafalcine right parietal lobe is again seen and is keeping with an old infarct.
This case is a mimic of the well known but rare Fahr disease. Originally Fahr disease was suggested as the favored differential but review of previous imaging revealed the findings were stable over many years and precipitated by a period of undiagnosed hypercalcaemia. Another differential would be benign senile calcification but this is thought unlikely because of the large amount of calcification.