{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T22:31:52Z","timestamp":1757543512273,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,26]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>A 51-year-old man presented with vertigo, slurred speech and left facial droop. He had been previously diagnosed with transient ischaemic attack (TIA) and had a prior lacunar infarct. Imaging showed heavy symmetrical calcification in the globus pallidus, frontal white matter and cerebellar dentate nuclei\/deep white matter. The imaging was pathognomonic for Fahr\u2019s disease and diagnosis was confirmed when other secondary causes of hypercalcemia were excluded. Fahr\u2019s disease is a rare, autosomal dominant, neurological condition characterised by primary brain calcification. Patients present with progressive neurological and psychiatric symptoms; commonly, Parkinsonian movement disorders, seizures, headaches, dysarthria, cognitive decline, psychosis and personality changes. There is an association with intracerebral ischaemic events. This case supports a growing body of anecdotal evidence of this association and is the first in which crescendo TIA may be the initial presentation of Fahr\u2019s disease. Referral for genetic counselling and symptomatic relief for neurological symptoms are the main management strategies.<\/jats:p>","DOI":"10.1136\/bcr-2021-242837","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T12:55:42Z","timestamp":1624971342000},"page":"e242837","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Fahr\u2019s disease with an initial presentation of crescendo TIA"],"prefix":"10.1136","volume":"14","author":[{"given":"Paul","family":"Smith","sequence":"first","affiliation":[{"name":"Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalun","family":"Ng","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kailash","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Stroke Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"2025082622423849000_14.6.e242837.1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-8-156"},{"key":"2025082622423849000_14.6.e242837.2","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1056\/NEJM197107082850202","article-title":"Familial calcification of the basal ganglions: a metabolic and genetic study","volume":"285","author":"Moskowitz","year":"1971","journal-title":"N Engl J Med"},{"key":"2025082622423849000_14.6.e242837.3","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(89)90199-6"},{"key":"2025082622423849000_14.6.e242837.4","first-page":"443","article-title":"[Transient focal ischemia in Fahr's disease]","volume":"13","author":"Bartecki","year":"1979","journal-title":"Neurol Neurochir Pol"},{"key":"2025082622423849000_14.6.e242837.5","first-page":"532","article-title":"Fahr's Syndrome- an interesting case presentation","volume":"7","author":"Asokan","year":"2013","journal-title":"J Clin Diagn Res"},{"key":"2025082622423849000_14.6.e242837.6","unstructured":"crescendo TIA . 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