Intracranial Calcifications



Intracranial Calcifications


Paula J. Woodward, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Maternal Infection



    • Cytomegalovirus


    • Toxoplasmosis


    • Varicella


Rare but Important



  • Teratoma


ESSENTIAL INFORMATION


Key Differential Diagnosis Issues



  • Significant overlap in imaging findings of in utero infections



    • Intrahepatic and intracranial calcifications most common findings


    • Intracranial calcifications may be non-shadowing and subtle


  • Requires maternal/fetal serologies to make definitive diagnosis


Helpful Clues for Common Diagnoses



  • Cytomegalovirus



    • Most common congenital infection


    • Main reservoir is children under < 2 years


    • Brain most commonly affected area



      • Calcifications (predominately periventricular), ventriculomegaly, microcephaly


    • Other findings include intrauterine growth restriction (IUGR), hepatosplenomegaly, cardiomyopathy, echogenic bowel and hydrops


  • Toxoplasmosis



    • Cats are definitive hosts: Oocyst shed in feces


    • Human infection from contaminated soil, water, undercooked meats


    • Non-shadowing intracranial and intrahepatic calcifications


    • Intracranial calcifications may be periventricular or random in distribution


    • Other findings include ventriculomegaly, IUGR and echogenic bowel


  • Varicella



    • Transplacental infection of fetus following maternal chickenpox infection


    • Intrahepatic and intracranial calcifications



      • May also see liver, heart, renal calcifications


    • Polyhydramnios due to neurologic impairment of swallowing


    • Limb hypoplasia and contractures


    • Paradoxical diaphragmatic motion on real time sonography due to unilateral paralysis


    • Cutaneous lesions in dermatomal distribution seen in neonate


Helpful Clues for Rare Diagnoses



  • Teratoma



    • Most common brain tumor in fetus


    • Obvious, large, destructive mass with cystic and solid components


    • Calcification most specific feature but not always present






Image Gallery









Coronal ultrasound focused on the frontal horns shows periventricular calcifications image. Only minimal shadowing is seen, which is typical.

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Related posts:

  1. Intracranial Cysts: Lateral
  2. Hepatomegaly
  3. Abnormal Placental Location
  4. Abnormal Umbilical Cord

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Aug 10, 2016 | Posted by in OBSTETRICS | Comments Off on Intracranial Calcifications

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