Extensive bilateral striocerebellar calcifications associated with Hashimoto’s hypothyroidism

Jing-Er Lee^a, Sung-Tsang Hsieh^{b, c}, Shinn-Kuang Lin^a, Kuo-Chuan Wang^d

^a Department of Neurology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
^b Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
^c Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
^d Department of Neurosurgery, National Taiwan University Hospital, Taipei, Taiwan

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Abstract
Intracranial calcifications are not uncommon radiographic findings and usually are nonpathological. However, striocerebellar calcifications may result from metabolic derangements, one common one being hypoparathyroidism. Here, we report a case of Hashimoto’s hypothyroidism where the patient experienced disturbance of consciousness and urinary incontinence and had extensive bilateral striocerebellar calcifications. After supplementation with levothyroxine, there were no more episodes of disturbed consciousness. Striocerebellar calcifications may be associated with metabolic derangement as a result of hypothyroidism, although the mechanism by which calcification occurs is not fully understood. Evaluation of thyroid function is recommended in patients with disturbed consciousness and striocerebellar calcifications.

Keywords
Hypothyroidism; Intracranial calcification; Striocerebellar calcification