Calcification of the Falx Cerebri: A Common Finding with Clinical Significance

Introduction

Calcification of the falx cerebri, a fibrous structure separating the cerebral hemispheres, is frequently observed on computed tomography (CT) scans. This calcification is generally considered physiological, a natural consequence of aging, and often goes unreported by radiologists. However, it warrants attention due to its potential clinical implications and differential diagnoses.

Occurrence and Pathogenesis

Calcification of the falx cerebri is common in the elderly population, affecting approximately 10% of individuals. It arises from embryonic mesenchymal cells, which occasionally ossify due to frictional hemorrhages or trauma. Additionally, calcifications may occur in the dura mater or tentorium cerebelli.

Clinical Significance

While often incidental, calcification of the falx cerebri can provide valuable clinical information. Its presence may suggest underlying conditions such as:

• Meningiomas: Calcifications in the falx cerebri can be associated with falcine meningiomas, tumors arising from the membrane covering the brain and spinal cord.
• Trauma: Severe head injuries can result in hemorrhages and subsequent calcification of the falx cerebri.
• Infections: Infections in the central nervous system, such as meningitis or encephalitis, can trigger inflammatory reactions leading to calcifications.

Diagnostic Considerations

Radiologists must carefully evaluate calcifications in the falx cerebri to rule out pathological processes. Differential diagnoses include:

• Dural and tentorial calcifications: These calcifications, occurring in the dura mater and tentorium cerebelli, respectively, can have similar appearances to calcification of the falx cerebri.
• Pathological calcifications: Calcifications resulting from abnormal tissue damage or disease, such as those seen in tumors or infections.

Conclusion

Calcification of the falx cerebri is a common finding on CT scans, usually considered physiological in elderly patients. However, it can provide clinical insights and should be interpreted in the context of other imaging findings and clinical history. Proper evaluation and differential diagnosis are essential to accurately assess its significance and prevent misinterpretation.