An 81-year-old woman with a past medical history of depression, dyslipidaemia and osteoarthritis, was brought to the emergency department after having been discovered lying on the floor at home with sphincter incontinence. The patient was alert and had aphasia, right hemiparesis and a cutaneous-plantar reflex in extension on the right side.
The Head CT did not show acute ischemia or signs of bleeding, however it did reveal exuberant degenerative calcifications in the globus pallidus (Figs. 1 and 2).
A repeat Head CT after 48h showed a hypodense image in the left Centrum Semiovale, confirming the diagnosis of an Ischemic Stroke.
There weren’t relevant laboratory parameters changes, namely in the calcium and phosphate metabolism, thus suggesting Fahr's Disease of probable degenerative etiology.
Fahr's Disease is a rare neurodegenerative disease, most commonly characterised by symmetrical calcium deposition in the basal ganglia or in other brain areas.1,2
It may be asymptomatic or present with psychiatric2,4 or neurological symptoms,1–3 these typically appear after the 4th decade of life.
It is not associated with other disorders of the calcium and phosphate metabolism or parathyroid hormone, unlike what occurs in Fahr's Syndrome.3–5 Cerebral calcification may be an accidental finding in approximately 1% of all head CT.6
