A Forgotten Rare Cause of Unilateral Basal Ganglia Calcinosis Due to Venous Angioma and Complicating Acute Stroke Management: A Case Report

被引：0

作者：

Balodis, Arturs ^{[1
,2
]}

Strautmane, Sintija ^{[3
,4
]}

Zarins, Oskars ^{[5
]}

Verzemnieks, Kalvis ^{[2
,6
]}

Vetra, Janis ^{[7
,8
]}

Pavlovics, Sergejs ^{[2
]}

Naudins, Edgars ^{[1
,2
]}

Kupcs, Karlis ^{[1
,2
]}

机构：

[1] Riga Stradins Univ, Dept Radiol, LV-1007 Riga, Latvia

[2] Pauls Stradins Clin Univ Hosp, Inst Diagnost Radiol, LV-1002 Riga, Latvia

[3] VCA Polyclin Plavnieki, LV-1021 Riga, Latvia

[4] Riga East Clin Univ Hosp, Dept Neurol, LV-1038 Riga, Latvia

[5] Riga Stradins Univ, Fac Med, 16 Dzirciema St, LV-1007 Riga, Latvia

[6] Univ Latvia, Dept Radiol, LV-1586 Riga, Latvia

[7] Pauls Stradins Clin Univ Hosp, Clin Neurol, LV-1002 Riga, Latvia

[8] Riga Stradins Univ, Dept Neurol, LV-1007 Riga, Latvia

来源：

DIAGNOSTICS | 2025年 / 15卷 / 03期

关键词：

unilateral basal ganglia calcinosis; venous angioma; developmental venous anomalies; complicated stroke management; neuroradiology; CALCIFICATION; ANOMALIES; BRAIN; HEMORRHAGE;

D O I：

10.3390/diagnostics15030291

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Unilateral basal ganglia calcinosis (BGC) is a rare radiological finding that can be diagnosed on computed tomography (CT) and magnetic resonance imaging (MRI) but often presents challenges for clinicians and radiologists in determining its underlying cause. So far, only a few potential causes that could explain unilateral BGC have been described in the literature. Case Report: A 54-year-old Caucasian male was admitted to a tertiary university hospital due to the sudden onset of speech impairment and right-sided weakness. The patient had no significant medical history prior to this event. Non-enhanced computed tomography (NECT) of the brain revealed no evidence of acute ischemia; CT angiography (CTA) showed acute left middle cerebral artery (MCA) M2 segment occlusion. CT perfusion (CTP) maps revealed an extensive penumbra-like lesion, which is potentially reversible upon achieving successful recanalization. However, a primary neoplastic tumor with calcifications in the basal ganglia was initially interpreted as the potential cause; therefore, acute stroke treatment with intravenous thrombolysis was contraindicated. A follow-up CT examination at 24 h revealed an ischemic lesion localized to the left insula, predominantly involving the left parietal lobe and the superior gyrus of the left temporal lobe. Subsequent gadolinium-enhanced brain MRI revealed small blood vessels draining into the subependymal periventricular veins on the left basal ganglia. Digital subtraction angiography was conducted, confirming the diagnosis of venous angioma. Conclusions: Unilateral BGC caused by venous angioma is a rare entity with unclear pathophysiological mechanisms and heterogeneous clinical presentation. It may mimic conditions such as intracerebral hemorrhage or hemorrhagic brain tumors, complicating acute stroke management, as demonstrated in this case. Surrounding tissue calcification may provide a valuable radiological clue in diagnosing venous angiomas DVAs and vascular malformations.

引用

页数：11

共 35 条

[1] Santucci G., Leach J., Ying J., Leach S., Tomsick T., Brain parenchymal signal abnormalities associated with developmental venous anomalies: Detailed MR imaging assessment, Am. J. Neuroradiol, 29, pp. 1317-1323, (2008)
[2] Sarp A.F., Batki O., Gelal M.F., Developmental Venous Anomaly with Asymmetrical Basal Ganglia Calcification: Two Case Reports and Review of the Literature, Iran. J. Radiol, 12, (2015)
[3] Osborn A.G., William H., Patricia W., Essentials of Osborn’s Brain: A Fundamental Guide for Residents and Fellows, (2019)
[4] Rammos S.K., Maina R., Lanzino G., Developmental venous anomalies: Current concepts and implications for management, Neurosurgery, 65, pp. 20-29, (2009)
[5] Idiculla P.S., Gurala D., Philipose J., Rajdev K., Patibandla P., Cerebral Cavernous Malformations, Developmental Venous Anomaly, and Its Coexistence: A Review, Eur. Neurol, 83, pp. 360-368, (2020)
[6] Hsu C.-T., Krings T., Symptomatic Developmental Venous Anomaly: State-of-the-Art Review on Genetics, Pathophysiology, and Imaging Approach to Diagnosis, Am. J. Neuroradiol, 44, pp. 498-504, (2023)
[7] Aoki R., Srivatanakul K., Developmental Venous Anomaly: Benign or Not Benign, Neurol. Med. -Chir, 56, pp. 534-543, (2016)
[8] Althobaiti E., Felemban B., Abouissa A., Azmat Z., Bedair M., Developmental venous anomaly (DVA) mimicking thrombosed cerebral vein, Radiol. Case Rep, 14, pp. 778-781, (2019)
[9] Li M., Fu Q., Xiang L., Zheng Y., Ping W., Cao Y., SLC20A2-Associated Idiopathic basal ganglia calcification (Fahr disease): A case family report, BMC Neurol, 22, (2022)
[10] Chen S.-Y., Ho C.-J., Lu Y.-T., Lin C.-H., Lan M.-Y., Tsai M.-H., The Genetics of Primary Familial Brain Calcification: A Literature Review, Int. J. Mol. Sci, 24, (2023)

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