TY - JOUR T1 - Looking beyond the obvious: cerebral calcification JF - Practical Neurology JO - Pract Neurol SP - 386 LP - 387 DO - 10.1136/practneurol-2013-000591 VL - 13 IS - 6 AU - Simon W Lines AU - Hawraman Ramadan Y1 - 2013/12/01 UR - http://pn.bmj.com/content/13/6/386.abstract N2 - A 63-year-old woman with advanced chronic kidney disease, diabetes mellitus, hypertension and peripheral vascular disease presented with three successive tonic–clonic seizures. She was obtunded, with a Glasgow coma scale score of 4/15 but with no lateralising neurological signs. She had marked renal impairment (serum creatinine 606 µmol/L (49–90) and estimated glomerular filtration rate of 6 mL/min/1.73 m2 (>60)). There was severe hyperparathyroidism (parathyroid hormone 48.8 pmol/L (1.7–7.6)). CT scan of the head found widespread infratentorial and supratentorial calcifications, unchanged from a CT scan 2 years before, and subtle acute subdural and subarachnoid haemorrhages (figure … ER -