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NEUROIMAGING
Year : 2018  |  Volume : 13  |  Issue : 1  |  Page : 120-121
 

Intracranial calcification in Down syndrome


Division of Pediatric Neurology, Department of Pediatrics, Dayanand Medical College and Hospital, Civil Lines, Ludhiana, Punjab, India

Date of Web Publication16-May-2018

Correspondence Address:
Dr. Jatinder S Goraya
Department of Pediatric Neurology, Dayanand Medical College and Hospital, Civil Lines, Ludhiana, Punjab 141001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JPN.JPN_114_17

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How to cite this article:
Sadana KS, Goraya JS. Intracranial calcification in Down syndrome. J Pediatr Neurosci 2018;13:120-1

How to cite this URL:
Sadana KS, Goraya JS. Intracranial calcification in Down syndrome. J Pediatr Neurosci [serial online] 2018 [cited 2019 Jun 20];13:120-1. Available from: http://www.pediatricneurosciences.com/text.asp?2018/13/1/120/232420




A 7-year-old girl was brought for the evaluation of cognitive and language delays. She was born to a cognitively normal 40-year-old mother by vaginal delivery at home. Her birth weight was 1000g only, and she was hospitalized for 1 month. She denied any seizures, involuntary movements, or psychiatric symptoms other than being “moody” at times. On examination, she weighed 14kg, and her height was 101cm and head circumference was 45cm. Physical examination revealed mongoloid facies and other characteristic physical findings of Down syndrome. Examination of lungs, heart, and abdomen was unremarkable. Neurological examination revealed only hypotonia.

Computed tomography (CT) of the brain showed brain parenchymal calcification involving bilateral globus pallidi [Figure 1] and head of right caudate nucleus [Figure 2]. Few specks of calcification were noted in gray–white matter border and white matter. Biochemistry revealed normal serum values for serum calcium, phosphorus, alkaline phosphatase, and parathyroid hormone. Chromosomal analysis showed trisomy 21 (47, XX +21).
Figure 1: Symmetrical hyperdensities (calcification) involving bilateral globus pallidi

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Figure 2: Calcification of head of right caudate

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Down syndrome is not recognized as a common cause of intracranial calcification,[1] even though it is a common finding on head CT, noted in 10.7%–26.7% cases of Down syndrome.[2],[3] Calcification predominantly involves basal ganglia with globus pallidus being the most common structure affected. Occasional cases with neurological symptoms have been reported,[4] but generally, there are no symptoms attributable to calcification. The pathogenesis of calcification in Down syndrome is not known.

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   References Top

1.
Patel PJ. Some rare causes of intracranial calcification in childhood: Computed tomographic findings. Eur J Pediatr 1987;13:177-80.  Back to cited text no. 1
    
2.
Ieshima A, Kisa T, Yoshino K, Takashima S, Takeshita K. A morphometric CT study of Down’s syndrome showing small posterior fossa and calcification of basal ganglia. Neuroradiology 1984;13:493-8.  Back to cited text no. 2
    
3.
Wisniewski KE, French JH, Rosen JF, Kozlowski PB, Tenner M, Wisniewski HM. Basal ganglia calcification (BGC) in Down’s syndrome (DS)–Another manifestation of premature aging. Ann N Y Acad Sci 1982;13:179-89.  Back to cited text no. 3
    
4.
Okano S, Takeuchi Y, Kohmura E, Yoshioka H, Sawada T. Globus pallidus calcification in Down syndrome with progressive neurologic deficits. Pediatr Neurol 1992;13:72-4.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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