Metabolic Craniopathy

Hyperostosis Frontalis Interna

“…None of these, however, demonstrated any other associated endocrine dysfunction. Grollman and Rousseau (1944) observed that the principal endocrine disturbances in their cases were amenorrhcea and hirsutism, and in two of the current group under review (aged 42 and 38) the amenorrhoea and hirsutism might possibly be important, but more likely are related to an early menopause. The low ketosteroid value (2-9 mg.) in Case 8 is attributable to old age (77).…”

“…Hypertension has been described in many reports. Grollman and Rousseau (1944) found it in 16 out of 40 patients, and Roth (1941) in five out cf eight. It was not, however, present in our series.…”

“…The results of metabolic investigation have hitherto varied. Grollman and Rousseau (1944) considered the principal metabolic anomaly to be obesity of the rhizomelic type, but in this group only two patients showed obesity to a slight degree. Roth (1941), on the other hand, found that six out of eight patients showed obesity, and, unlike Grollman and Rousseau's patients, all his eight cases gave a diabetic type of curve on glucose tolerance test; also two of Roth's patients gave increased values for serum calcium.…”

“…Grollman and Rousseau (1944) found calvarial hyperostosis in 78 or 4-1 % of 1,620 skulls of mental patients in North Carolina. No authors have so far described a consistent or specific neuropsychiatric picture which they found associated with hyperostosis frontalis interna in a significant number of cases.…”

“…This came to be called the Morgagni, or Morgagni-Stewart- Morel, syndrome. Hyperostosis, discovered at necropsy or radiologically, is not very uncommon in psychiatric conditions, and this may have tempted many authors to assume a causal relationship, for in many papers there is no clear definition of the syndrome and the bony changes are loosely spoken of as if they constituted the syndrome itself. Grollman and Rousseau (1944) have even stated that the diagnosis could be made without x-ray confirmation of bony change. Sherwood Moore (1936b) found hyperostosis frontalis interna in 1-44% of 6,650 skulls examined radiologically, and calvarial hyperostosis of all sorts in a total of 3-48%, from which he defined a symptom complex which he referred to as " metabolic craniopathy ".…”