Hyperostosis frontalis interna: A Nubian case

Abstract

The aim of this article is to present evidence of hyperostosis frontalis interna in a 40-year-old female recovered from a Meroitic cemetery (ca. 300 A.D.) in Sudanese Nubia. A review of the literature concerning the Morgagni-Stewart-Morel (MSM) syndrome suggests that the changes in the skull fragment are consistent with this diagnosis. This case is the earliest example of the condition so far reported, and therefore, in archaeological time and space, this is a disease not only of modern civilization, but also of antiquity. Current endocrinological reports suggest that the hyperostosis is the hallmark of a generalized disorder of bone metabolism, with increased androgens, prolactin, and somatotropins. Hyperostosis frontalis interna is the central feature of a syndrome first described over 200 years ago by the early pathologist Giovanni Batistta Morgagni, professor of anatomy at Padua (1719). He found thickening of the internal tables of the frontal bones in association with virilism and obesity. Stewart (1928) and Morel (1929) independently added several neuropsychiatric problems to this complex and questioned the possibility of an endocrine basis for the syndrome.

A Comparison of Radiological and Palaeopathological Diagnostic Criteria for Hyperostosis Frontalis Interna

“…The difference between ancient and modern populations is striking, and has been commented upon by several researchers. 10,11 Armelagos suggests that this high frequency in contemporary populations may re¯ect an increase in longevity'. Others agree with this argument, but some go much further.…”

Hyperostosis frontalis interna: What does it tell us about our health?

“…It is extremely rare among historic populations (following age adjustment), whereas in modern populations, HFI is a common phenomenon with a 5% frequency in males and 25% in females (Antón, 1997;Armelagos and Chrisman, 1988;Hershkovitz et al, 1999;Lazer, 1996;Moore, 1955). HFI etiology has not yet been fully clarified; however, previous studies have associated it with hormonal imbalance due to its high prevalence and severity in postmenopausal females, and the fact that only males with hypogonadism manifest advance stages of HFI (Hershkovitz et al, 1999;Moore, 1955;Perou, 1964;Ramchandren and Liebeskind, 2007;Yamakawa et al, 2006).…”

Two neolithic cases of Hyperostosis frontalis interna

“…Even though HFI has been clearly identified in Homo erectus and Neandertalians (Antó n, 1997), it seems to be relatively rare in osteo-archeological series (Anderson, 1993;Armelagos & Chrisman, 1988;Barber et al, 1997;Stroud & Kemp, 1993;Watrous et al, 1993), leading to the conclusion that perhaps HFI should be considered a modern phenomenon.…”