open access

Ahead of Print
Original article
Submitted: 2021-11-16
Accepted: 2021-12-08
Published online: 2021-12-16
Get Citation

The morphologic analysis of a not well-known anatomical structure’s calcifications (Bochdalek’s Flower Basket Calcifications)

E. Doğan1, C. Elibol1
DOI: 10.5603/FM.a2021.0136
·
Pubmed: 34966996
Affiliations
  1. Department of Radiology, Faculty of Medicine, Mugla Sıtkı Koçman University, Mentese, Mugla, Turkey

open access

Ahead of Print
ORIGINAL ARTICLES
Submitted: 2021-11-16
Accepted: 2021-12-08
Published online: 2021-12-16

Abstract

Background: The aim of the study is to define the morphology of calcifications belonging to a not very well-known anatomical structure [Calcification of foramen of luchka/Bochdalek’s flower basket calcification (Boc FBC)].

Materials and methods: 264 computed tomography (CT)s belong to healthy patients were included in the study [50.0038 ± 24.78309 (0-92 years old) (mean age± SD; range)]. The morphology of the calcifications in the fourth ventricle (CFV) and Boc FBC was evaluated and compared with other common intracranial calcifications in each patient.

Results: Boc FBC was detected in 22.35% (59/264) of the patients. Out of 101 patients whose age is above 60 years old, 59 presented Boc FBC (the rate increased to 55,45%), thus in our sample 94,91% of the detected Boc FBCs (56/59) were seen after 60 years old. No Boc FBC was found under the age of 50. Statistically, there is a highly significant correlation between Boc FB and Pineal / habenular (p<0.01) as well as choroid plexus calcifications (p<0.01). The correlation between CFV and Boc FBC was significant (p<0.05). 37.3% of Boc FBCs had a conical form. This form was not accompanied by any vascular calcifications (VC) neither basilar nor vertebral. Therefore, seeing the conical form was valuable in the differential diagnosis.

Conclusions: In our study, Boc FBCs are seen in advanced age and are not encountered under the age of fifty. The conical form is seen in one-third of the cases, but it is a very beneficial finding for distinguishing Boc FBC from other calcifications if any. In the advanced age group calcifications; especially choroidal plexus calcifications and pineal/habenular calcifications; are highly associated with Boc FBC. In the presence of CFV, the probability of encountering Boc FBC is very high.

Abstract

Background: The aim of the study is to define the morphology of calcifications belonging to a not very well-known anatomical structure [Calcification of foramen of luchka/Bochdalek’s flower basket calcification (Boc FBC)].

Materials and methods: 264 computed tomography (CT)s belong to healthy patients were included in the study [50.0038 ± 24.78309 (0-92 years old) (mean age± SD; range)]. The morphology of the calcifications in the fourth ventricle (CFV) and Boc FBC was evaluated and compared with other common intracranial calcifications in each patient.

Results: Boc FBC was detected in 22.35% (59/264) of the patients. Out of 101 patients whose age is above 60 years old, 59 presented Boc FBC (the rate increased to 55,45%), thus in our sample 94,91% of the detected Boc FBCs (56/59) were seen after 60 years old. No Boc FBC was found under the age of 50. Statistically, there is a highly significant correlation between Boc FB and Pineal / habenular (p<0.01) as well as choroid plexus calcifications (p<0.01). The correlation between CFV and Boc FBC was significant (p<0.05). 37.3% of Boc FBCs had a conical form. This form was not accompanied by any vascular calcifications (VC) neither basilar nor vertebral. Therefore, seeing the conical form was valuable in the differential diagnosis.

Conclusions: In our study, Boc FBCs are seen in advanced age and are not encountered under the age of fifty. The conical form is seen in one-third of the cases, but it is a very beneficial finding for distinguishing Boc FBC from other calcifications if any. In the advanced age group calcifications; especially choroidal plexus calcifications and pineal/habenular calcifications; are highly associated with Boc FBC. In the presence of CFV, the probability of encountering Boc FBC is very high.

Get Citation

Keywords

Foramen Luschka, Bochdalek' s flower basket, computed tomography, intracranial calcifications

About this article
Title

The morphologic analysis of a not well-known anatomical structure’s calcifications (Bochdalek’s Flower Basket Calcifications)

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2021-12-16

Page views

155

Article views/downloads

82

DOI

10.5603/FM.a2021.0136

Pubmed

34966996

Keywords

Foramen Luschka
Bochdalek's flower basket
computed tomography
intracranial calcifications

Authors

E. Doğan
C. Elibol

References (26)
  1. Adigun OO, Al-Dhahir MA. Anatomy, Head and Neck, Cerebrospinal Fluid. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 2021 Jul 26. 2020.
  2. Al-Ameri L, Al-Zuhairi E, Al-Shirwani H. Prevalence of pineal gland and choroid plexus calcification among iraqi patients attending CT scan units. Int J Morphol. 2021; 39(1): 244–251.
  3. Barany L, Baksa G, Patonay L, et al. Morphometry and microsurgical anatomy of Bochdalek's flower basket and the related structures of the cerebellopontine angle. Acta Neurochir (Wien). 2017; 159(8): 1539–1545.
  4. Bradac GB, Simon RS, Fiegler W, et al. A radioanatomical study of the choroid plexus of the fourth ventricle. Neuroradiology. 1976; 11(2): 87–91.
  5. Daghighi MH, Rezaei V, Zarrintan S, et al. Intracranial physiological calcifications in adults on computed tomography in Tabriz, Iran. Folia Morphol. 2007; 66(2): 115–119.
  6. Engelhardt E, Moreira DM. Bochdalek’s flower basket. Rev Bras Neurol. 2019; 55(3).
  7. Granger A, Kim S, Kollias T, et al. Ossification of the falx cerebri: A review. Transl Res Anat. 2017; 7: 20–22.
  8. Guo Z, Li D, Xie Y, et al. Secondary cerebellopontine angle oligodendroglioma after cranial irradiation: A case report and literature review. Int J Neurosci. 2021 [Epub ahead of print]: 1–7.
  9. Hirata T, Umekawa M, Sato K, et al. Isolated intracranial mass lesion near the foramen of Luschka: An unusual presentation of granulomatosis with polyangiitis. Interdisciplinary Neurosurgery. 2021; 25: 101106.
  10. Hodges TR, Karikari IO, Nimjee SM, et al. Calcifying pseudoneoplasm of the cerebellopontine angle: case report. Neurosurgery. 2011; 69(1 Suppl Operative): onsE117–onsE120.
  11. Horsburgh A, Kirollos RW, Massoud TF. Bochdalek's flower basket: applied neuroimaging morphometry and variants of choroid plexus in the cerebellopontine angles. Neuroradiology. 2012; 54(12): 1341–1346.
  12. Hubert V, Chauveau F, Dumot C, et al. Clinical imaging of choroid plexus in health and in brain disorders: a mini-review. Front Mol Neurosci. 2019; 12: 34.
  13. Johal J, Paulk PB, Oakes PC, et al. A comprehensive review of the foramina of Luschka: history, anatomy, embryology, and surgery. Childs Nerv Syst. 2017; 33(9): 1459–1462.
  14. Johansson PA. The choroid plexuses and their impact on developmental neurogenesis. Front Neurosci. 2014; 8: 340.
  15. Kıroğlu Y, Callı C, Karabulut N, et al. Intracranial calcifications on CT. Diagn Interv Radiol. 2010; 16(4): 263–269.
  16. Loukas M, El-Sedfy A, Tubbs RS, et al. Vincent Alexander Bochdalek (1801-1883). World J Surg. 2008; 32(10): 2324–2326.
  17. Modic MT, Weinstein MA, Rothner AD, et al. Calcification of the choroid plexus visualized by computed tomography. Radiology. 1980; 135(2): 369–372.
  18. Nakagawa T, Arita H, Kijima N, et al. Primary central nervous system lymphoma of the bilateral Bochdalek’s flower baskets: A case report. Interdisciplinary Neurosurgery. 2020; 21: 100756.
  19. Paladini D. The hidden story of the fourth ventricular choroid plexus: the flower basket of an old anatomist…. Ultrasound Obstet Gynecol. 2021; 58(4): 505–508.
  20. Peters N, Baltin C, Barham M, et al. An unusual finding: Heterotopic ossification located in the subcutis of the iliac region – A case report in the context of current literature. Transl Res Anat. 2021; 25: 100137.
  21. Rao P, Thibodeau R, Jafroodifar A, et al. Hypervascular vestibular schwannoma: A case report and review of the literature. Radiol Case Rep. 2021; 16(10): 2841–2846.
  22. Saade C, Najem E, Asmar K, et al. Intracranial calcifications on CT: an updated review. J Radiol Case Rep. 2019; 13(8): 1–18.
  23. Sharifi M, Ungier E, Ciszek B, et al. Microsurgical anatomy of the foramen of Luschka in the cerebellopontine angle, and its vascular supply. Surg Radiol Anat. 2009; 31(6): 431–437.
  24. Tubbs RS, Shoja MM, Aggarwal A, et al. Choroid plexus of the fourth ventricle: Review and anatomic study highlighting anatomical variations. J Clin Neurosci. 2016; 26: 79–83.
  25. Yalcin A, Ceylan M, Bayraktutan OF, et al. Age and gender related prevalence of intracranial calcifications in CT imaging; data from 12,000 healthy subjects. J Chem Neuroanat. 2016; 78: 20–24.
  26. Żytkowski A, Skrzat J, Mazurek A, et al. Clinical relevance of the caroticoclinoid foramen – A case report and concise literature review. Transl Res Anat. 2021; 25: 100153.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl