PICTORIAL INTERLUDE

37         SA JOURNAL OF RADIOLOGY • June 2007

Bilateral symmetrical calcification of the basal ganglia is a frequently 
encountered incidental finding on CT scan. The aetiology of adult 
basal ganglia calcification ranges from a physiological type secondary 
to aging, which may be regarded as a normal variant, to the less typical 
pathological causes. Physiological basal ganglia calcification is usually 
punctate, localised in the globus pallidus and of no clinical significance. 
If accompanied by other calcification one should then consider an 
underlying pathological condition. Endocrine diosorders, e.g. hypo-
parathyroidism, pseudohypoparathyroidism and hyperparathyroidism 
are the more commonly recognised pathological causes of basal ganglia 
calcification.1,2 

The calcification may be dense and its distribution frequently 
involves the caudate and lentiform nuclei, thalami, dentate nuclei of the 
cerebellum and subcortical regions (Figs 1 and 2). The above non-con-
trast axial CT in a 60-year-old patient with known pseudohypoparathy-
roidism demonstrates an example thereof. 

1.    Oliveira JR, Spiteri E, Sobrido MJ, et al. Genetic heterogeneity in familial idiopathic basal ganglia 
calcification (Fahr disease). Neurology 2004; 63: 2165-2167. 

2.    Verulashvili IV, Glonti LSH, Maniia MN, et al. Basal ganglia calcification:  
clinical manifestations and diagnostic evaluation. Georgian Med News 2006; 140: 39-43.  
 
 

Pathological basal ganglia calcification in a 
patient with pseudohypoparathyroidism 

L Sweidan, MB ChB
Division of Radiology, Department of Radiation Sciences, University of the 

Witwatersrand, Johannesburg 

Fig. 1. Dense calcification of the dentate nuclei bilaterally.

Fig. 2. Dense calcification of the basal ganglia, thalami, nuclei and  
subcortical white matter.

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