open access

Vol 81, No 2 (2022)
Original article
Submitted: 2021-11-16
Accepted: 2021-12-08
Published online: 2021-12-16
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The morphologic analysis of a not well-known anatomical structure’s calcifications (Bochdalek’s flower basket calcifications)

E. Doğan1, C. Elibol1
·
Pubmed: 34966996
·
Folia Morphol 2022;81(2):435-441.
Affiliations
  1. Department of Radiology, Faculty of Medicine, Mugla Sıtkı Koçman University, Mentese, Mugla, Turkey

open access

Vol 81, No 2 (2022)
ORIGINAL ARTICLES
Submitted: 2021-11-16
Accepted: 2021-12-08
Published online: 2021-12-16

Abstract

Background: The aim of the study was to define the morphology of calcifications belonging to a not very well-known anatomical structure (calcification of foramen of Luschka/Bochdalek’s flower basket calcification [Boc FBC]).
Materials and methods: Two hundred sixty-four computed tomography (CT) scans obtained from healthy patients were included in the study (50.0038 ± 24.78309 [0–92 years old] [mean age ± standard deviation; 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 aged above 60 years, 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 of age. No Boc FBC was found under the age of 50. Statistically, there was a highly significant correlation between Boc FBC 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). It was found that 37.3% of Boc FBCs had a conical form. This form was not accompanied by any vascular calcifications, either basilar or vertebral. Therefore, seeing the conical form was valuable in the differential diagnosis.
Conclusions: In our study, Boc FBCs were seen in advanced age and were not encountered under the age of 50. The conical form was seen in one-third of the cases, but it was a very beneficial finding for distinguishing Boc FBC from other calcifications if any. In the advanced age group, calcifications, especially choroid 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 was to define the morphology of calcifications belonging to a not very well-known anatomical structure (calcification of foramen of Luschka/Bochdalek’s flower basket calcification [Boc FBC]).
Materials and methods: Two hundred sixty-four computed tomography (CT) scans obtained from healthy patients were included in the study (50.0038 ± 24.78309 [0–92 years old] [mean age ± standard deviation; 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 aged above 60 years, 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 of age. No Boc FBC was found under the age of 50. Statistically, there was a highly significant correlation between Boc FBC 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). It was found that 37.3% of Boc FBCs had a conical form. This form was not accompanied by any vascular calcifications, either basilar or vertebral. Therefore, seeing the conical form was valuable in the differential diagnosis.
Conclusions: In our study, Boc FBCs were seen in advanced age and were not encountered under the age of 50. The conical form was seen in one-third of the cases, but it was a very beneficial finding for distinguishing Boc FBC from other calcifications if any. In the advanced age group, calcifications, especially choroid 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.

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Keywords

foramen of 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

Vol 81, No 2 (2022)

Article type

Original article

Pages

435-441

Published online

2021-12-16

Page views

4877

Article views/downloads

1003

DOI

10.5603/FM.a2021.0136

Pubmed

34966996

Bibliographic record

Folia Morphol 2022;81(2):435-441.

Keywords

foramen of 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.

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