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.

Medical Advice (Q&As) on “What Causes Calcified Granuloma of Brain?

  1. Nitu jhakar

    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?

    Reply
    1. Buddy M.D. Post author

      Can you share the complete MRI report? Is there any edema/ swelling around the granuloma? What are her symptoms?

      Reply
  2. deepak

    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

    Reply
    1. Buddy M.D. Post author

      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.

      Reply
  3. Murali

    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.

    Reply
    1. Buddy M.D. Post author

      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.

      Reply
      1. Murali

        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.

        Reply
          1. Murali

            Thank you so much Sir for your patience and detailed responses.
            I really like the way you are responding.
            Thank you once again.

  4. VINOD KUMAR

    BRAIN MRI REPORT – MY SON A CALCIFIED GRANULOMA MEASURING 4X4 MM IS NOTED IN RIGHT PARIETAL LOBE WITH MILD SURROUNDING EDEMA
    PLEASE SUGGEST

    Reply

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