Clinical question : evaluate for interval change for punctate hemorrhage/calcification seen on outside head CT. Signs and symptoms: 21 month old with sickle cell trait, history of altered mental status, staring spells and questionable evaluate for interval change of punctate hemorrhage or calcification.COMPARISON none Nonenhanced head CT:There are relatively symmetrical punctate and linear calcifications bilateral basal ganglia calcification. There is no associated edema or encephalomalacia with these findings. The coronal and sagittal reformatted images suggest that the calcifications appear to be along a similar course as of the lenticulostriate arteries. The exact etiology of this findings are not clear. Follow-up with an enhanced MRI is recommended to better assess these findings and in particular the surrounding brain parenchyma. There may be slight prominence of cortical sulci for patient's stated age of one year. There is no evidence of intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. There is no evidence of any additional calcification in the brain parenchymal or the subependymoma region.Calvarium is intact. Mastoid air cells, middle ear cavities and limited view of the orbits are unremarkable. The
Symmetrical bilateral linear calcification of basal ganglia with no associated edema or encephalomalacia of unknown etiology. Recommend follow-up with an enhanced MRI. Please see above comments.