Cerebral leukoencephalopathy with calcifications and cysts operated for signs of increased intracranial pressure: case report

Background: Association of leukoencephalopathy with calcifications and cysts is extremely rare. It should be differentiated from FD or bilateral striopallidodentate calcinosis and astrocytoma. Yet, there are many other clinical syndromes featuring bilateral symmetric cerebral calcifications. Neuroradiologic and histopathologic findings are more helpful than clinical picture in differentiating these 3 entities from each other. Case Description: We report a sporadic case operated for signs of increased ICP and cerebellar cystic mass. The patient had symmetric. bilateral cerebral and cerebellar calcifications, white matter edema, and a secondary thalamic cyst as well. After resection of the cerebellar mass, clinical picture returned to normal and edematous findings on MRI resolved in addition to a decrease in size of the thalamic lesion on follow-up. Conclusion: Patients with findings of cystic cerebral calcifications on CT scans should be followed cautiously for acute deterioration because surgery is indicated in cases having signs of increased intracranial pressure. (C) 2009 Elsevier Inc. All rights reserved.