Table 1.
Patient information and relevant clinical history of the seven patients.
Fig 1.
Hippocampal calcifications on CT scans of patient numbers 4 (mild, A), 1 (moderate, B-D) and 3 (severe, E). (A) Axial reconstructed image with mild hippocampal calcification (one dot). (B) Coronal reconstructed image shows (moderate) bilateral hippocampal calcification (multiple dots), indicated by arrows. Choroid plexus calcification is indicated by arrowheads. (C) Axial reconstructed image with moderate bilateral hippocampal calcification marked with arrows. (D) Sagittal reconstructed image with moderate hippocampal calcification marked with an arrow and choroid plexus calcification marked with an arrowhead. (E) Axial reconstructed image shows severe hippocampal calcification (confluent) indicated by an arrow and calcification of the choroid plexus is indicated with an arrowhead.
Table 2.
Overview of hippocampal calcifications on CT scan and in histological study.
Fig 2.
Coronal brain slice after dissection of the brain (of patient number 1).
(A) Coronal slice with the posterior part of the hippocampus (tail). (B) Close up of the posterior part of the hippocampus (scale bar = 10 mm). Choroid plexus is visible in the lateral ventricle. The close up shows the sample for further histological staining.
Fig 3.
Severe calcifications in the tail of the left hippocampus (hippocampus number 1) of patient number 1 (as described in Tables 1 and 2).
(A) HE stain overview of the left hippocampal tail. Scale bar = 1 mm, 4x magnification. (B) Von Kossa-positive deposits in precapillaries and capillaries (arrowheads) in the molecular layer of the DG and CA1. Calcifications of the bigger vessels, mostly arteria (arrow), in the molecular layer of CA1 are clearly observed. Two arteria which are calcified are surrounded, one in the molecular layer of the CA1 and one in the granular layer of the DG. The calcifications spread out into the molecular layer of the subiculum. Scale bar = 600 μm, 10x magnification. (C) Zoomed in on the big calcifications of precapillaries, capillaries and bigger vessels in the molecular layer of the DG and CA1. Epithelial cells of the vascular wall are not seen, because of the big calcification deposits. Scale bar = 400 μm, 20x magnification. (D) Enlarged image of a von Kossa-positive calcified artery in the molecular layer of the CA1. Calcification of the tunica adventitia (arrow) and the tunica media (arrowhead) are identified. Scale bar = 200 μm, 40x magnification. (E) Calcified artery in the granular layer of the DG shown with Elastica van Gieson stain. Calcification of the tunica adventitia (arrow) and the tunica media (arrowhead) are identified. Scale bar = 100 μm, 40x magnification.
Fig 4.
Calcification of precapillaries and capillaries in the right hippocampal tail (hippocampus number 2) of patient number 1 (as described in Tables 1 and 2).
(A) Overview of the right hippocampal tail. Scale bar = 1 mm, 4x magnification. (B) Zoomed picture of von Kossa-positive stain, calcifications are located in the precapillaries and capillaries (arrows) in the right hippocampal tail. Scale bar = 100 μm, 40x magnification.
Fig 5.
Calcification of the choroid plexus on the left side of patient number 1.
The dark red/black dots, some are indicated with yellow arrows, are calcifications of precapillaries and capillaries in the choroid plexus on the left side of the brain. Scale bar = 1 mm, 20x magnification.