It was first described in 1719 by Morgagni as a pathology accompanying virilism and obesity 3. type E: severe hyperostosis frontalis interna with soft tissue expansion.type D: continuous nodular bony formations involving more than 50% of the frontal endocranium.type C: nodular bony formations occupying up to 50% of the frontal bone.But in adulthood, a change in height doesnt occur. In childhood, this leads to increased height and is called gigantism. type B: nodular bony formations occupying less than 25% of the frontal bone When you have too much growth hormone, your bones increase in size.type A: endocranial frontal bone elevations less than 10 mm in diameter.The Hershkovitz classification was modified to include a fifth grade of severity after a cadaveric study in 2011 described hyperostotic findings at the falx cerebri 1,3. Hyperostosis frontalis interna is classified into four grades of severity based on Hershkovitz's morphological and histopathological findings 1. These include a genetic predisposition, angiosomes of numerous vascular anastomoses on the frontal bone of the calvaria and the estrogen theory 3. Nodular endocranial remodeling may result in compression of the cerebrum. The etiology and pathogenesis are not well understood although many theories have been proposed. Compression by calvarial thickening may lead to cerebral atrophy and may present with cognitive impairment, neuropsychiatric symptoms, headaches and epilepsy 1, 3. Clinical presentationĪs hyperostosis frontalis interna is usually an incidental finding of no clinical significance patients are generally asymptomatic. It is most common in women over the age of 65 with 87% of severe hyperostosis frontalis interna occurring in this cohort of patients 3. Post mortem studies report a prevalence of 12% 3.
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