Fahr’s disease (FD) is a rare neurologic disorder characterized by the symmetric and bilateral intracerebral calcification in a patient. We describe the case of a 65-year-old woman who presented with gait disturbance, abnormal mentality, and visual field defect. The result of a brain computerized tomography showed spontaneous intracranial hemorrhage in the right parieto-occipital area, and also showed the incidence of symmetric and bilateral intracerebral calcification. Moreover, laboratory studies indicated characteristic hypoparathyroidism. This brings us to understand that additionally, one of her sons also presented with similar intracerebral calcification, and was subsequently diagnosed with FD. Thus, her case was consistent with that of a patient experiencing FD. The patient had hypertension, which we now know might have caused the intracerebral hemorrhage. However, this patient’s brain lesions were in uncommon locations for spontaneous intracerebral hemorrhage, and the lesions were noted as occurring away from the identified heavily calcified areas. Thus, it seemed that the massive calcification of cerebral vessels in the basal ganglia, the most common site of intracerebral hemorrhage, might have prevented a hypertensive intracerebral hemorrhage. Eventually, an intracerebral hemorrhage occurred in an uncommon location in the patient’s brain.

Citations

• Aneurysmal subarachnoid hemorrhage with PFBC and beta thalassemia: a case report
  Kuangyang Yu, Jinwei Pang, Xiaobo Yang, Jianhua Peng, Yong Jiang
  BMC Neurology.2023;[Epub]     CrossRef
• Decoding brain calcifications: A single-center descriptive case series and examination of pathophysiological mechanisms
  Bahadar S Srichawla, Eduardo Andrade, Vincent Kipkorir
  SAGE Open Medical Case Reports.2023;[Epub]     CrossRef
• Fahr’s syndrome associated with hypoparathyroidism: A case report
  Mukesh Kumar Sarna, Pallaavi Goel, Varun Bhargava, Rishabh Parakh
  Journal of the Royal College of Physicians of Edinburgh.2023; 53(4): 283.     CrossRef
• Nontraumatic spontaneous bilateral intracerebral haemorrhage in a young patient: a rare case report
  Pramodman Singh Yadav, Sagar Panthi, Aakash Neupane, Manish Uprety, Rochana Acharya, Leeza Shah, Ajmat Ansari, Ujjwal Basnet, Raksha Bhattarai, Bhawani Khanal
  Annals of Medicine & Surgery.2023; 85(5): 1830.     CrossRef
• Hypoparathyroidism with Fahr’s syndrome: A case report and review of the literature
  Yuan-Yuan Zhou, Ying Yang, Hong-Mei Qiu
  World Journal of Clinical Cases.2019; 7(21): 3662.     CrossRef

Acute retropharyngeal calcific tendinitis is a rare benign condition which is characterized by acute neck pain and stiffness, and dysphagia. In this report, we present 2 cases of retropharyngeal calcific tendinitis patients. The first patient complained of neck pain and stiffness. The second patient had neck pain and hypophonia. In both cases, CT and MRI of the cervical spine demonstrated prevertebral effusion of the upper cervical spine with calcification at C1-C2 level. Acute neck pain and stiffness improved with oral administration of nonsteroidal anti-inflammatory drug. Follow-up radiologic findings revealed the disappearance of prevertebral effusion and calcification. (J Korean Acad Rehab Med 2009; 33: 718-722)

Objective
To evaluate the effect of low-energy extracorporeal shock wave therapy (ESWT) in refractory calcifying epicondylitis. Method: Twelve patients (1 man, 11 women, mean age 49), who suffered from refractory medial or lateral epicondylitis (mean duration 22 months) with sonographically verified calcification, were included. Subjects were classified according to radiologic and sonographic findings of calcification. Visual analogue scale (VAS) at rest and activities of daily living (ADL) as well as Nirschl score were evaluated before and 3 months after low-energy (0.06∼0.12 mJ/mm², 1,500∼ 2,000 shocks) extracorporeal shock wave therapy (ESWT). Sonographic changes and Roles and Maudsley score were assessed 3 months after ESWT. Results: VAS at rest and ADL as well as Nirschl score were significantly decreased (p＜0.05) after ESWT. Roles and Maudsley score was "Good" in six patients (50%), "Acceptable" in 3 (25%) and "Poor" in 3 (25%) after 3 months. In sonographic classification, "Fragmented type" was observed in five (42%), "Nodular" in 3 (25%), "Small" in 4 (33%). All of eight radiologically positive patients (67%) showed sonographic changes of calcification including one complete resorption (8%), 3 disintegration (25%) and 4 decrease of size or number (33%). All of four radiologically negative patients (33%) were "Small type" and did not show any change of calcification on sonography. Conclusion: Low-energy ESWT can help the clinical improvement and resorption of calcification in refractory calcifying medial or lateral epicondylitis. Radio-opaque calcification may be a good indicator of resorption of calcification on sonography after low-energy ESWT. (J Korean Acad Rehab Med 2007; 31: 711-717)