Six different extremely calcified lesions of the brain: brain stones

Abstract

BackgroundThis study aimed to extend clinical documentation of cerebral calculi by reporting six cases of cerebral calculi with distinct etiologies and localizations. MethodsWe evaluated the age, sex distribution, presenting symptoms, neurological examination findings, pathology results, and location of the calcifications of six patients with intracranial calcifications.ResultsThree of the six patients with brain stones were female (50%), and three were male (50%). The patient ages ranged from 12 to 46 years. A radiological examination of each patient’s cranium was performed with pre-operative cranial computed tomography and magnetic resonance imaging. All of the lesions were completely excised. The patients’ pathologies were determined to be distinct hyalinization, dystrophic calcification, hamartoma, ossification developing from widespread pituitary adenoma tissue, benign mesenchymal neoplasia, a mass consisting of sporadically ossified fibrous tissue, and angiomatous meningioma with distinct hyalinization and fibrosis.ConclusionsIntracranial calcifications are a common phenomenon in neurosurgical practice. However, brain stones, as well as solid calcifications also termed cerebral calculi, are rarely encountered. Brain stones can be classified on the basis of their etiology and localization. Additionally, we suggest that lesions smaller than 1 cm might be classified as calcifications and those greater than 1 cm as brain stones. We further suggest that the differentiation between calcification and brain stones might be based on size. These pathologies typically manifest as seizures and are occasionally identified during routine brain tomography. Meningiomas constitute an important portion of extra-axial calcifications, whereas tumorous and vascular causes are more prevalent among intra-axial calcifications.

Intracranial Gorgon: Surgical Case Report of a Large Calcified Brain Arteriovenous Malformation

“…Despite AVMs being the second most common vascular malformation of the brain to present calcifications [5], the pathophysiological mechanisms of partial completely calcified AVMs are as of yet uncertain. It has been stipulated that this phenomenon is a result of chronic venous ischemia and repeated hemorrhages [4,5]. Among other suspected factors are inflammation, vasculitis, and intraluminal thrombosis, some of the lesions becoming angiographically occult [4,5,14].…”

“…Brain arteriovenous malformations (AVMs) are rare benign intracranial vascular anomalies consisting of an amalgamation of convoluted vessels receiving arterial blood and shunting it directly into a venous drainage [1][2][3]. Despite this not being frequently mentioned, AVM calcification is present in up to 25-30% of cases and may account for the second highest number of calcified vascular lesions, behind only cavernous malformations [4,5]. Epileptic seizures are the most common form of presentation for unruptured AVMs, and the second most frequent presenting symptom overall, behind only hemorrhage [1][2][3][4][5][6][7][8][9].…”

“…Despite this not being frequently mentioned, AVM calcification is present in up to 25-30% of cases and may account for the second highest number of calcified vascular lesions, behind only cavernous malformations [4,5]. Epileptic seizures are the most common form of presentation for unruptured AVMs, and the second most frequent presenting symptom overall, behind only hemorrhage [1][2][3][4][5][6][7][8][9]. Endovascular embolization and stereotactic radiosurgery are therapeutic alternatives, though it is thought that surgical resection of AVM yields the best and earliest results in controlling related symptoms [1][2][3]10,11].…”

Pituitary Adenoma with Calcifications: A Case Report

“…In patients observed with having cavernous malformations, the vascular lesion most frequently shows calcification, with an incidence rate of 40-60%. These lesions' resemblance is like popcorn kernels [5]. The second observed vascular lesions with calcification are caused by arteriovenous malformations.…”

“…A well-circumscribed lobe-shaped calcified formation in the suprasellar or parasellar region likely indicates a possible aneurysm. Larger aneurysms tend to calcify, resulting in calcification settling in the walls of the blood vessel, and resulting in intraluminal thrombosis [5].…”