Physiological Intracranial Calcifications in Children

Abstract

Objectives: Physiological intracranial calcifications (PICs) are benign in nature and related to aging. We aimed to study the frequency of physiological intracranial calcifications (PICs) in pediatric population using computed tomography (CT). Methods: The brain CT scans of consecutive patients (age range, 0-15 years) who had visited Sultan Qaboos University Hospital from January 2017 to December 2020 were retrospectively assessed for the presence of PICs. The presence of calcifications was identified using 3 mm thick axial images, and coronal and sagittal reformats. Results: A total of 460 patients were examined and the mean age was 6.54 ± 4.94 years. The frequency of PIC in boys and girls was 35.1% and 35.4%, respectively. PICs were most common in choroid plexus with 35.21% (age range 0.4 -15 years; median, 12 years), followed by the pineal gland in 21.08% (age range 0.5 -15 years; median, 12 years) and the habenular nucleus in 13.04% of subjects (2.9 -15 years; median, 12 years). PICs were less common in falx cerebri with 5.86% (age range 2.8-15 years; median, 13 years) and tentorium cerebelli in 3.04% (age range 7-15 years; median, 14 years) of subjects. PICs increased significantly with increasing age (p<0.001). Conclusion: Choroid plexus is the most frequent site of calcification. Choroid plexus and pineal gland calcifications may be present at less than 1 year of age. Recognizing PICs is clinically important for radiologists as they can be mistaken for hemorrhage or pathological entities like neoplasms or metabolic diseases. Keywords: Calcification; Pineal gland; Dura Mater; Brain; Computed Tomography