Contribution of CT scan to the diagnosis of Fahr's syndrome

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Abstract
Of 7040 patients who were examined with CT scan for various reasons, 72 (1.02%) showed symmetrical intracranial calcifications. On the basis of the extent of the calcifications, the patients were divided into 3 groups of which the 1st (10 cases), with extensive calcifications, showed clear findings of hypoparathyroidism; the 2nd (4 cases), with less extensive calcifications, showed borderline laboratory findings and the 3rd (58 cases), with calcifications only in the internal part of the globus pallidus, had no relation to any disturbance of the parathyroid function. The limited percentage (4.2%) of calcifications detected by ordinary cranial X-rays was discussed as compared to those diagnosed by CT scan; this was due to the weakening of the relationship which existed in the past between hypoparathyroidism and calcifications. Patients with extensive calcifications did not have a significantly higher proportion of neurological impairment (35.8%) than patients who showed limited calcifications (34.5%). Patients with extensive calcifications showed more frequent mental disorders (50%) compared to those who showed limited calcifications (34.5%). The proportion of mental disorders was higher in patients with dilatation of the subarachnoid spaces (56.7%) compared to those who did not show dilatation (23.8%). Of the 72 patients with calcifications, 15 (20.8%) showed extrapyramidal syndrome, possibly due to Ca salt deposits in the metasynaptic dopamine receptors while 13 (18%) were taking anticonvulsant drugs which, apart from influencing the metabolism of Ca, inlfuenced the activity of alkaline phosphatase and were involved in the creation of calcifications.