IMAGES IN EMERGENCY MEDICINE
Intracranial bilateral symmetric calcification in hypoparathyroidism
1 Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
2 Ulsan Fire Department Headquarters, Ulsan, Republic of Korea
Correspondence to:
Dr S P Chung, Department of Emergency Medicine, Yongdong Severance Hospital, Dogok-dong, Gangnam-gu, Yonsei University College of Medicine, Seoul, 135-720, Republic of Korea; emstar@naver.com
Accepted 16 June 2007
| The first 150 words of the full text of this article appear below. |
A 42-year-old woman presented to the emergency department with a complaint of tremors in both extremities, torticollis, and agitation that had lasted 10 h. When she was 24 years old, she underwent a total thyroidectomy due to thyroid cancer. The results of her laboratory tests were consistent with hypoparathyroidism, probably secondary to undiagnosed chronic hypoparathyroidism after thyroidectomy 18 years earlier.
Intracranial calcifications may be an incidental finding, but they can result from many causes. Chronic hypoparathyroid syndrome is characterised by the presence of extrapyramidal signs (dyskinesia, choreiform, and athetoic movements, tremors, and cogwheel rigidity), cerebellar manifestations (dysarthria, ataxia), psychosis, and epilepsy.1
These computed tomography findings (fig 1) can be found in Fahr disease. It has also been reported predominantly in cases of autosomal dominant inheritance. A thorough laboratory workup, however, ruled out other conditions associated with brain calcifications, including hypoparathyroidism, systemic lupus erythematosus, and other infectious, genetic, or
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