Incidence of hyperostosis frontalis interna in patients at a general hospital and at a mental hospital

Hawkins, Tom; Martin, L

doi:10.1136/jnnp.28.2.171

Cited by 15 publications

(12 citation statements)

References 2 publications

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“…Previous reports on HFI (e.g., Barber et al, 1997;Arensburg, 1989;Marlet, 1974;Hawkins and Martin, 1965;Salmi et al, 1962;Moore, 1955;Gershon-Cohen et al, 1955;Oldberg, 1945;Eldridge and Holm, 1940) raised some of these questions without providing adequate resolution. According to Anton (1997), the difficulty in answering these questions may relate to sample bias, inadequate population size, or an overreliance on X-ray studies which tend to overlook relatively mild cases.…”

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confidence: 99%

“…HFI has rarely been documented in the archaeological record (e.g., Watrous et al, 1993;Stroud and Kemp, 1993;Anderson, 1993;Farwell and Molleson, 1993;Armelagos and Chrisman, 1988), despite its antiquity (Anton, 1997;Armelagos and Chrisman, 1988). In contrast, it has been demonstrated with considerable frequency in contemporary populations of postmenopausal women (Arensburg, 1989;Marlet, 1974;Hawkins and Martin, 1965;Salmi et al, 1962;Moore, 1955;Gershon-Cohen et al, 1955;Calame, 1951;Henschen, 1949;Oldberg, 1945;Eldridge and Holm, 1940;Morel, 1930). Whether HFI is unreported in the archaeological record, or if there has actually been a change in its frequency remains unclear.…”

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confidence: 99%

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Hyperostosis frontalis interna: An anthropological perspective

Hershkovitz

Greenwald

Rothschild

et al. 1999

Am. J. Phys. Anthropol.

141

175

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Hyperostosis frontalis interna (HFI) is manifested by the accretion of bone on the inner table of the frontal bone. Despite the vast literature on HFI, ambiguity exists as to its etiology, osteogenesis, demography, and history. This stimulated the present broad-scale study of HFI which included the evaluation of 1,706 early 20th century skulls (1,007 males and 699 females) from the Hamann-Todd and Terry human osteological collections, as well as 2,019 pre-19th century East-Mediterranean, Amerindian, and Central European skulls. In addition, 72 cadavers were dissected for gross inspection and histology. Special attention was paid to the relationship of the brain and meninges to endocranial lesions. HFI is an independent condition, not a symptom of a more generalized syndrome as suggested in the past. It can appear in a variety of forms but each is the result of the same process and probably of the same etiology. Investigators' previous failure to recognize the mild stages of HFI (types A and B) as an early form of the general HFI process led to erroneous statistics and interpretations of observations. HFI should also be considered a phenomenon separate from HCI, hyperostosis cranialis diffusa (HCD), and other endostoses, even when it appears in association with them. To avoid ambiguity and facilitate the description of cranial hyperostoses, uniform nomenclature (HFI, HCD) has been recommended. HFI is rarely seen in historic populations, regardless of geographical origin. It is most commonly found among females and is believed to be associated with prolonged estrogen stimulation. While its magnitude of manifestation and frequency are much higher in females, HFI is not a purely female phenomenon. Males with hormonal disturbances such as atrophic testis were found to manifest HFI type D. HFI is associated with age insofar as it is much less frequent in females under 40 years of age. Although advanced cases of HFI (types C and D) have been observed in individuals as young as 40 years of age, it is more frequently found after age 60. The frequency of HFI type D will not increase from age 60. Type-predicted analysis by cohort reveals significant ethnic differences. Changes in African American (AA) females appear earlier in life and progress more rapidly than in European American (EA) females. Analysis of radiographs shows a discrepancy between the anatomic prevalence of HFI and its radiological recognition, which is very poor for mild cases. This apparently resulted in the misconceptions that HFI is entirely an old-age phenomenon, and that it is exclusively female. Histological analysis shows that the inner table along with the closely attached dural layer play a major role in the osteogenesis of HFI. Contrary to previous models, no evidence for diploe or ectocranial plate involvement was found. Cadaver study suggests that the predilection for the frontal area may be related to an altered blood supply and/or vascular stretching.

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confidence: 99%

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confidence: 99%

Hyperostosis frontalis interna: An anthropological perspective

Hershkovitz

Greenwald

Rothschild

et al. 1999

Am. J. Phys. Anthropol.

141

175

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“…More recent archeological evidence documents a 32.4% incidence of HFI in adult Anasazi with an 8.3% incidence in males and 44% incidence in females (Mulhern et al, 2006). However, the incidence of HFI in modern populations appears to be much higher than in historic populations regardless of geographic origin with a higher incidence in women (Eldridge and Holm, 1940;Gershon-Cohen et al, 1955;Moore, 1955;Hawkins and Martin, 1965;Anderson, 1991Anderson, , 1992Sohmiya et al, 2001). In modern populations, the incidence has been reported at 5-12%, but the incidence in women (24%) is higher than that in men (5.2%) (Armelagos andChrisman, 1988, Hershkovitz et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

A case of extensive hyperostosis frontalis interna in an 87‐year‐old female human cadaver

2008

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Hyperostosis frontalis interna (HFI) is a condition that involves thickening of the inner surface of the frontal bone with sparing of the midline. Little is known about the etiology and clinical presentation of HFI. We report unusual findings in a woman with extensive Type D hyperostosis of the frontal bone and a large hyperostotic nodule in the parietal bone with impingement on the precentral gyrus, distinguishing this from the common form of HFI. The scalp was dissected from the cranial vault, and the calvaria and brain were removed and digitally imaged. Bone specimens were embedded in methyl methacrylate plastic, sectioned, and stained using the Von Kossa Method with MacNeal's tetrachrome. Medical records were reviewed, and additional history was obtained through interviews with the donor's family. The calvaria had extensive, bilateral thickening of the frontal bone with irregular topography and clearly demarcated borders. The dura was adherent to all hyperostotic regions. A 3.5-cm nodule was visible on the inner table of the left parietal bone. The dura and cerebrum showed compression in this region, but it was unclear if this resulted in clinical ramifications. Microscopic analysis revealed a larger proportion of cancellous bone was present in regions of macroscopic hyperostosis. Quantitative analysis of sections through areas of gross hyperostosis demonstrated a lower proportion of lamellar bone than in the control. The patient exhibited symptoms that have been correlated to HFI in previous studies. We suggest that the HFI disease process was responsible for the manifestation of these symptoms in this patient.

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“…It also appears to occur most often in individu als over the age of 40 (Hershkovitz et al 1999). Despite much discussion in the anthropologi cal and medical literature (e.g., Armelagos and Chrisman 1988;Hawkins and Martin 1965;Hershkovitz et al 1999;Jaffe 1972;Salmi et al 1962), the specific etiology and effects of the dis order remain to be determined. HFI has been associated with syndromes that include viril ism and obesity in women, as well as mental disorders (Hawkins and Martin 1965).…”

Section: Miscellaneous Skeletal Disordersmentioning

confidence: 99%

“…Despite much discussion in the anthropologi cal and medical literature (e.g., Armelagos and Chrisman 1988;Hawkins and Martin 1965;Hershkovitz et al 1999;Jaffe 1972;Salmi et al 1962), the specific etiology and effects of the dis order remain to be determined. HFI has been associated with syndromes that include viril ism and obesity in women, as well as mental disorders (Hawkins and Martin 1965). However, Hershkovitz et al (1999) determined that HFI is an independent phenomenon, and other research ers have found that HFI can be asymptomatic (Jaffe 1972;Salmi et al 1962).…”

Section: Miscellaneous Skeletal Disordersmentioning

confidence: 99%