Calcificação de núcleos da base do cérebro: estudo anatomopatológico de 4 casos

Queiroz, Aristides Cheto de; Malbouisson, Ana Maria Blanco

doi:10.1590/S0004-282X1981000300009

Resumos

O trabalho consta do estudo anatomopatológico de 4 casos de calcificação de núcleos da base do cérebro, entidade que está mais relacionada a distúrbio metabólico endócrino do tipo hipoparatireoidismo e pseudohipoparatireoidismo. O estudo mostra a associação da deposição cálcica nos núcleos da base com lesão calcificada do cerebelo (cortex e núcleo denteado) em 2 casos. Demonstra também a presença não só de cálcio mas também de ferro nas lesões e a distribuição de manguito perivascular, característica dos depósitos. A ausência de uma doença básica comum e a falta de qualquer distúrbio metabólico associado, permite caracterizar estes casos como sendo de natureza idiopática ou pelo menos de causa não determinada.

The paper reports the pathological study of 4 autopsied cases of massive basal ganglia calcifications, an entity that although related to hypoparathyroidism or pseudohypoparathyroidism, some times can be considered as idiopathic. In our cases no metabolic disturb or any common related disease could be found in association. Interesting is to point out that the lesion is confined to the central nervous system, with no foci of calcification outside the brain. There is a characteristic perivascular distribuition of the deposits that, as demonstrated by histochemical study are composed by ron besides calcium.

Calcificação de núcleos da base do cérebro: estudo anatomopatológico de 4 casos

Calcification of basal ganglia: a study of 4 autopsied cases

Aristides Cheto de Queiroz^I; Ana Maria Blanco Malbouisson^II

^IProfessor Assistente do Departamento de Anatomia Patológica e Medicina Legal da Universidade Federal da Bahia, Bolsista do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

^IIResidente do Serviço de Anatomia Patológica do Hospital Prof. Edgard Santos, Bolsista do CNPq

RESUMO

O trabalho consta do estudo anatomopatológico de 4 casos de calcificação de núcleos da base do cérebro, entidade que está mais relacionada a distúrbio metabólico endócrino do tipo hipoparatireoidismo e pseudohipoparatireoidismo. O estudo mostra a associação da deposição cálcica nos núcleos da base com lesão calcificada do cerebelo (cortex e núcleo denteado) em 2 casos. Demonstra também a presença não só de cálcio mas também de ferro nas lesões e a distribuição de manguito perivascular, característica dos depósitos. A ausência de uma doença básica comum e a falta de qualquer distúrbio metabólico associado, permite caracterizar estes casos como sendo de natureza idiopática ou pelo menos de causa não determinada.

SUMMARY

The paper reports the pathological study of 4 autopsied cases of massive basal ganglia calcifications, an entity that although related to hypoparathyroidism or pseudohypoparathyroidism, some times can be considered as idiopathic. In our cases no metabolic disturb or any common related disease could be found in association. Interesting is to point out that the lesion is confined to the central nervous system, with no foci of calcification outside the brain. There is a characteristic perivascular distribuition of the deposits that, as demonstrated by histochemical study are composed by ron besides calcium.

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Trabalho realizado no Serviço de Anatomia Patológica do Hospital Prof. Edgard Santos, Salvador, Bahia.

Serviço de Anatomia Patológica - Hospital Prof. Edgard Santos - 40.000 Salvador, B A. - Brasil.

1. ALEXANDER, L. & MYERSON, A. - The mineral content of various cerebral lesions as demonstrated by microincineration methods. Am. J. Path. 13:405, 1937.
2. BAGCHI, A. K.; SEN, S.; ROY, C. K. & CARMEL, S. - Some observation on calcified intracranial space occupying lesions. Neurol. India 24:77, 1976.
3. BENNET, J. C; MAFFLY, R. H. & STEINBACH, H. L. - Significance of bilateral basal ganglia calcification. Radiology 72:368, 1959.
4. CHON-WAH, A. & MASEL, M. B. - Cerebral calcification following pseudomonas meningitis in an infant. Aust. Radiol. 16:56, 1972.
5. COPELAND, D. D.; LAMB, W. L. - Calcification of basal ganglia and cerebelar roof nuclei in metally defective patient with hidrotic ectodermal dysplasia: Analysis of intracranial concretions by electron microprode. Neurology 27:1.029, 1977.
6. FLAMENT-DURANT, J.; KETELBANT-BALASSE, P. MAURUS, R.; REGNIER, R. & SPERHL, M. - Intracerebral calcifications appearing during the course of acute lymphocytic leukemia treated with methotrexate and X rays. Cancer 35:319, 1975.
7. GARWICZ, S. - Cerebral calcifications associated with intrathecal methotrexate therapy in acute lymphocytic leukemia. J. Pediatrics 90:496, 1977.
8. HALL, P. - Calcification of the basal ganglia apparently presenting as a Schizophreniform psychosis. Postgrad. Med. J. 48:636, 1972.
9. ICHINOSE, H.; HARKIN, J. C. & LITTLE, W. P. - Massive calcification of basal ganglia. Bull. Tulane Univ. Med. Faculty 26:91, 1967.
10. KLAWANS, H. L.; LUFTON, M. & SIMON, L. - Calcification of the basal ganglia as a cause of levodopa-resistant parkinsonism. Neurosci. Behav, Physiol. 26:221, 1976.
11. MAFFEI, W. E. - Organização e estrutura geral do sistema motor extra-piramidal. In Fundamentos da Medicina. Editado por Fundo Procienx. São Paulo 1967, pg. 558.
12. NUMAGUCHI, J.; HOFFMAN, J. C. & SONES, P. J. - Basal ganglia calcification as a late radiation effect. Am. J. Roentgenol. Radium Thec. Nucl. Med. 123:27, 1975.
13. PRICE, R. A. & BIRDWELL, D. A. - The central nervous system in childhood leukemia III - mineralizing microangiopathy and dystrophic calcification. Cancer 42:717, 1978.
14. QUEIROZ, A. C. - Incrustaçfio ferruginosa de neurônios nos infartos cerebrais. Arquivos de Neuro-Psiquiatria (São Paulo) 34:62, 1976.
15. REEDER, M. M. - Multiple intracranial calcifications. Semin. Roentgenol. 11:13, 1976.
16. ROWEN, M.; SINGER, M. & MORAN, T. - Intracranial calcification in the congenital rubella syndrome. Am. J. Roetgenol. Radium Ther. Nucl. Med. 15:86, 1972.
17. SCHAFER, J. A.; BERG, B. O.
18. SCHEY, W. L. - Intracranial calcifications in childhood. Frequency of occurence and significance. Am. J. Roentgenol. Radium Ther. Nucl. Med. 122:495, 1974.
18. SMITH, K. D.; GERACI, A. & LUPARELLO, F. J. - Basal ganglia calcification in postoperative hypoparathyroidism. N. Y. State J. Med. 73:1.807, 1973.

Datas de Publicação

Publicação nesta coleção
17 Ago 2012
Data do Fascículo
Set 1981

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALEXANDER, L. & MYERSON, A. - The mineral content of various cerebral lesions as demonstrated by microincineration methods. Am. J. Path. 13:405, 1937.

[2] 2. BAGCHI, A. K.; SEN, S.; ROY, C. K. & CARMEL, S. - Some observation on calcified intracranial space occupying lesions. Neurol. India 24:77, 1976.

[3] 3. BENNET, J. C; MAFFLY, R. H. & STEINBACH, H. L. - Significance of bilateral basal ganglia calcification. Radiology 72:368, 1959.

[4] 4. CHON-WAH, A. & MASEL, M. B. - Cerebral calcification following pseudomonas meningitis in an infant. Aust. Radiol. 16:56, 1972.

[5] 5. COPELAND, D. D.; LAMB, W. L. - Calcification of basal ganglia and cerebelar roof nuclei in metally defective patient with hidrotic ectodermal dysplasia: Analysis of intracranial concretions by electron microprode. Neurology 27:1.029, 1977.

[6] 6. FLAMENT-DURANT, J.; KETELBANT-BALASSE, P. MAURUS, R.; REGNIER, R. & SPERHL, M. - Intracerebral calcifications appearing during the course of acute lymphocytic leukemia treated with methotrexate and X rays. Cancer 35:319, 1975.

[7] 7. GARWICZ, S. - Cerebral calcifications associated with intrathecal methotrexate therapy in acute lymphocytic leukemia. J. Pediatrics 90:496, 1977.

[8] 8. HALL, P. - Calcification of the basal ganglia apparently presenting as a Schizophreniform psychosis. Postgrad. Med. J. 48:636, 1972.

[9] 9. ICHINOSE, H.; HARKIN, J. C. & LITTLE, W. P. - Massive calcification of basal ganglia. Bull. Tulane Univ. Med. Faculty 26:91, 1967.

[10] 10. KLAWANS, H. L.; LUFTON, M. & SIMON, L. - Calcification of the basal ganglia as a cause of levodopa-resistant parkinsonism. Neurosci. Behav, Physiol. 26:221, 1976.

[11] 11. MAFFEI, W. E. - Organização e estrutura geral do sistema motor extra-piramidal. In Fundamentos da Medicina. Editado por Fundo Procienx. São Paulo 1967, pg. 558.

[12] 12. NUMAGUCHI, J.; HOFFMAN, J. C. & SONES, P. J. - Basal ganglia calcification as a late radiation effect. Am. J. Roentgenol. Radium Thec. Nucl. Med. 123:27, 1975.

[13] 13. PRICE, R. A. & BIRDWELL, D. A. - The central nervous system in childhood leukemia III - mineralizing microangiopathy and dystrophic calcification. Cancer 42:717, 1978.

[14] 14. QUEIROZ, A. C. - Incrustaçfio ferruginosa de neurônios nos infartos cerebrais. Arquivos de Neuro-Psiquiatria (São Paulo) 34:62, 1976.

[15] 15. REEDER, M. M. - Multiple intracranial calcifications. Semin. Roentgenol. 11:13, 1976.

[16] 16. ROWEN, M.; SINGER, M. & MORAN, T. - Intracranial calcification in the congenital rubella syndrome. Am. J. Roetgenol. Radium Ther. Nucl. Med. 15:86, 1972.

[17] 17. SCHAFER, J. A.; BERG, B. O.

[18] 18. SCHEY, W. L. - Intracranial calcifications in childhood. Frequency of occurence and significance. Am. J. Roentgenol. Radium Ther. Nucl. Med. 122:495, 1974.

[19] 18. SMITH, K. D.; GERACI, A. & LUPARELLO, F. J. - Basal ganglia calcification in postoperative hypoparathyroidism. N. Y. State J. Med. 73:1.807, 1973.