Delayed onset of dementia and parkinsonism in a postoperatory hypoparathyroidism case

Introduction. Brain imaging is mandatory for dementia diagnosis. In various guidelines and clinical studies MRI stands as the first choice, with the highest sensitivity and specificity. Our goal here is to show the exception to the rule. CT remains an imaging method important for diagnosis of pathology characterized by basal ganglia calcifications. Case history. A female patient, aged 60 years, came to the hospital with symptoms of mild cognitive impairment and parkinsonian syndrome. A medical history of hypertension and total thyroidectomy were recorded. The first imaging option for patient was to perform a brain MRI, which did not bring any information about the cause of dementia. Fortunately a CT was performed as well and bilateral basal ganglia massive calcifications were seen, which were due to total thyroidectomy / parathyroidectomy in the past. Conclusion. To diagnose secondary cognitive disorders of basal ganglia calcifications a standard head CT seems to be the method of choice.