Calcified Granulomatous Lesions of Brain
Whenever an inflammation occurs, the tissue affected respond producing an inflammatory exudate and a granuloma is formed. A granuloma in the brain is nothing but a localized area of inflammation.
This inflammation may be due to some infection, vascular problem, injury or any other trigger.
Products of inflammation are formed there. Inflammatory exudate along with WBC’S, pus cells, sloughed tissue debris etc. is present in the granuloma.
Calcified Granuloma
As a granuloma becomes old, it may calcify. Therefore, calcification of granulomas indicate that they have been there since a long time. This is a natural process.
This can be compared with scar formation, which is easily observed over the superficial wounds of our body. A fresh wound heals slowly to produce a harder covering over it. Under this cover, repair work takes place and new healthy cells are formed.
This is called scar formation, which is similar to calcification of a granuloma.
Possible Reasons of Brain Inflammations That May Lead to Granuloma Formation
- Trauma or injury to the brain
- Stroke or stroke-like episode, which may have caused reduced blood supply to that particular area of the brain. This may have led to infarction. Such a situation is common in people presenting with long standing high blood pressure.
- Infection of that brain area- encephalitis, meningitis etc. as seen in tuberculosis and other infectious diseases.
- Inflammations caused by autoimmune disorders like amyloidosis, rheumatoid disorders, multiple sclerosis etc.
- Any brain tumor
- In conditions like worm infestations like cysticercosis. The eggs of the worm may reach the brain and elicit an inflammatory response there.
Effects of a Granuloma
A granuloma is a space occupying lesion (SOL) in the brain tissue. It presses over the adjoining brain cells. This affects the functioning of those cells.
Depending upon the area of the brain where the granuloma is present, various brain functions may get affected. The affected individual may get severe headaches, nausea, fits (convulsions) or some focal deficit.
Focal deficits may include complete or partial loss of vision, impaired hearing, affected speech or any other body function.
A granuloma may be active or inactive ( also called dormant).
In an active one, inflammation is going on and fresh products of inflammation are being produced. Whereas, inactive granulomas are dormant, showing no activity on repeated CT scans. They are usually calcified and hard on appearance. They do not increase in size. Repeated CT’s may show shrinkage of such lesions.
Management
Since a granuloma is a space occupying lesion in the brain, there are chances that it may press upon the adjoining tissues to produce symptoms.
Therefore, most of the patients presenting with this problem are given an anti-epileptic medication as a prophylaxis. Some patients may require pain medications for headaches or other symptoms they are facing.
The treatment is essentially controlling the symptoms, to start with.
Next step is assessing whether the granuloma is active or not. If active, cause of granuloma formation is investigated and this underlying cause is treated.
It is possible that the infection is still there and actively causing inflammation in the brain tissue. This may be a bacteria, virus or even a parasite. Accordingly, medicines are given to combat the infection.
Anti- inflammatory medicines are given to reduce inflammation and to prevent the granuloma from increasing in size.
Sometimes, if the location of the granuloma permits, surgical excision of the lesion may be done.
Inactive or dormant granulomas tend to shrink in size on their own. Except for symptomatic treatment, no medical intervention is required for them.
Dear dr.
My mother is diagnosed with focal calcified lesion of size 5.2mm in right posteriir parietal lobe and it is suggestive of healed granuloma along with type 2 diabetes malitus siezure disorder
Sir I want to know that how long it take to cure completely or any surgery is required ? and upto which extend it is severe plus is there any chances to reoccurrance of this granuloma after treatment?
Can you share the complete MRI report? Is there any edema/ swelling around the granuloma? What are her symptoms?
my wife who is having trouble in head and pressure in ears Dr. has advised for NCCT test. The test revels the findings:-
1. 10 mm calcified granuloma is seen in lef high frontal lobe adjacent to calvarium without perilesional edema
Likely to be an inactive lesion in the brain. Your doctor may run a few more test to investigate the cause before deciding treatment.
Such lesions are usually inactive and not dangerous. They may shrink with time to almost disappear. Let her avoid non vegetarian food, alcoholic beverages or smoking. These may aggravate the problem in many cases.
Thanks sir I had seen her to RML hospital neurosurgeon he said there is no need to worry.
Wishing her health!
Hi Sir,
My mother had MRI scan and these things came out in report.
Sub centimeter calcified granuloma showing blooming on GRE noted in right middle frontal gyrus.
Suspicious neurovascular compromise noted between AICA and 8th nerve within the left IAC.
Diffuse cerebral atrophy with small vessel ischemic changes.
Kindly advise on how to proceed with the treatment.
Lesions are progressive in nature. You’ll need to see a neurologist, at the earliest , for treatment.
Deficient blood supply to the brain may be leading to Cerebral atrophy, which needs to be checked urgently.
Hi Sir,
We consulted neurologist and he directed us to consult a Neurosurgeon and we are yet to meet a Neurosurgeon.
Could you please suggest if a surgery is required or can this be cured with medication. Thank you for the prompt response.
Surgery is not required in most of such cases.
Thank you so much Sir for your patience and detailed responses.
I really like the way you are responding.
Thank you once again.
You’re welcome.
BRAIN MRI REPORT – MY SON A CALCIFIED GRANULOMA MEASURING 4X4 MM IS NOTED IN RIGHT PARIETAL LOBE WITH MILD SURROUNDING EDEMA
PLEASE SUGGEST
Since there’s edema surrounding the lesion, this appears- to be a lesion of recent origin. Also, it may be active. Your doctor may need to give him medicines to curb it.
How old is he? What are his symptoms? Can you share full MRI report here.
Sir, I have a old calcified lesion in my left posterior parietal love, most likely ncc according to my mri report. Sir is there any possibility that it can grow? Also can a brain tumor be mistaken as a calcified lesion?
I used to have eye twitches three years ago for which the doctor gave me lacosamide. I have had those medicines for three years then i had a mri dones which shows no shrinkage nor increase in my calcified lesion. Do i need to continue lacosamide. Please guide me doctor. I am scared beyond imagination.
My lesion is 13 mm * 12 mm. Is that too big for a calcified granuloma? Should I be worried?
It’s unlikely for a calcified lesion to be a brain tumor.
If the lesion shows no shrinkage with time, you need to continue with the medicine.
dear sir
I need your help we right hand pain & brain pain already MRI SCAN BUT no any clear
Findings Are Suggestive Of Old Granulomatous Lesions In Left Parietal Resion To Be Correlated Clinically
MRI REPORT
Pain is usually a pressure symptom. Some active lesion is likely to be there that is pressing over your nerves, giving pain.
Old lesions are usually inactive. Needs to be investigated more.
Sir, it’s been three years but my calcified granuloma (12mm) has not shrunk in size. There is no evidence of edema though. I am having antiepileptics for past three years for some eye twitching that i had three years ago. Now doctor said it’s ok to stop medicine as I am getting married. I am scared why is my granuloma not shrinking? Can it cause fits now that I am stopping meds?
Though your doctor would be the best person to assess this, in general, no edema indicates that the lesion is inactive.
However, you’ll need to be watchful for sometime after stopping the medicines.
Sir, i had a calcified granuloma three years ago. There was no edema and the gramuloma stayed the same in the last mri 8 months ago. There was no edema in both mri. I have even stopped my anti seizure meds some months ago.
However, i have some head pressure and dizziness for some months now. Doctor thinks it is anxiety and has given me anti anxiety meds but could it be possible that the calcified granuloma has become active again???
Please help.
Yes, it may be. Repeat scanning is the only way to ascertain it.
Calcified granuloma can become active again??? Isnt it old and healed???
It may get active again in some cases.
Sir can i please consult you? I need a good neurologist urgently. I cannot find anyone. You are a great human being. Please help me consult you. Let me know if u can give me some phone number, some online site anything