Radiographic Synopsis

PA, lateral and oblique projections. Conventional radiography often provides initial information concerning the presence, size, shape and approximate location of intracranial calcifications. However, because of its exquisite sensitivity to calcium compounds and ability to display both the bony skull and its content, CT is the method of choice in this setting. MRI is often required for better delineation of the underlying pathology and its extent, or for exclusion of pathology in cases of isolated benign calcification (Uhlenbrock et al. 1990; Smith 1992).

1. Microcephaly; increased calvarial and skull base thickening, most prominent in the frontal and parieto-occipital areas; basal ganglia calcifications (Cockayne syndrome)

2. Mild microcephaly; skull hyperostosis (not mandatory); orbital hypertelorism (40%); dental anomalies; cleft lip/palate (not mandatory); basal ganglia calcifications (oculo-dento-osseous dysplasia)

3. Microcephaly;brain calcifications (pseudo-TORCH syndrome, Aicardi-Goutières syndrome, TORCH infections)

4. Lamellar calcification of falx cerebri, tentorium, diaphragma sellae, and petroclinoid ligament; calcified brain neoplasms (not mandatory); macro-cephaly, with frontal and parietal bossing (nevoid basal cell carcinoma syndrome)

5. 'Railroad track' peripheral, brain gyral calcification; unilateral calvarial thickening, enlargement of mastoids and paranasal sinuses, with facial asymmetry (Sturge-Weber syndrome)

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