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Insights into Imaging
Published in: Insights into Imaging 5/2013

Open Access 01-10-2013 | Pictorial Review

Brain stones revisited—between a rock and a hard place

Authors: Froilan G. Celzo, Caroline Venstermans, Frank De Belder, Johan Van Goethem, Luc van den Hauwe, Thijs van der Zijden, Maurits Voormolen, Tomas Menovsky, Andrew Maas, Paul M. Parizel

Published in: Insights into Imaging | Issue 5/2013

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Abstract

Objectives and methods

Large intracranial calcifications are occasionally encountered in routine computed tomography (CT) scans of the brain. These calcifications, also known as “brain stones”, can be classified according to location and aetiology. Combining imaging findings with relevant clinical history and physical examination can help narrow down the differential diagnosis and may allow confident diagnosis in certain situations.

Results

This article provides a pictorial review illustrating various clinical entities resulting in brain stones.

Discussion

Based on location, brain stones can be classified as extra- or intra-axial. Extra-axial brain stones comprise tumours and exaggerated physiological calcifications. Intra-axial brain stones can further be classified according to aetiology, namely neoplastic, vascular, infectious, congenital and endocrine/metabolic. Imaging findings combined with essential clinical information can help in narrowing the differential diagnosis, determining disease state and evaluating effect of therapy.

Teaching Points

• Based on location, brain stones can be either extra- or intra-axial.
• Extra-axial brain stones comprise tumours and exaggerated physiological calcifications.
• Intra-axial aetiologies include neoplastic, vascular, infectious, congenital and endocrine/metabolic.
• CT scan is the mainstay in identifying and characterising brain stones.
• Certain MRI sequences (gradient echo T2* and susceptibility-weighted imaging) are considered adjunctive.
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Metadata
Title
Brain stones revisited—between a rock and a hard place
Authors
Froilan G. Celzo
Caroline Venstermans
Frank De Belder
Johan Van Goethem
Luc van den Hauwe
Thijs van der Zijden
Maurits Voormolen
Tomas Menovsky
Andrew Maas
Paul M. Parizel
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
Insights into Imaging / Issue 5/2013
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1007/s13244-013-0279-z

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