Program Director University of Charleston Bolivar, Missouri, United States
Abstract Body : Introduction / Objective: Hyperostosis frontalis interna (HFI), often seen as a benign finding, involves the accumulation of bone on the inner surface of the frontal bone, with a reported frequency in post-menopausal females ranging from 5% to 18%. Determined by frontal bone thickness and observed waviness or nodular contours, HFI's etiology remains elusive, with hormonal stimulation proposed as a potential factor. A documented correlation between HFI and dementia exists. This case series explores outcomes from routine dissection of 10 cadavers, 5 with a history of dementia.
Materials / Methods: The research methodology was a case series, comprising cadaveric dissection of 10 donors with 5 having a documented history of dementia. Histological studies or computed tomography (CT) data were not available for analysis. The dissection included the removal of cranial skin from the outer skull, followed by the extraction of the calvaria and brain. The examination of the frontal bone was compared to the documented history of dementia.
Results: Among 10 donors examined, a distinction emerged between those with a history of dementia to those without. In 5 donors with dementia, observations revealed a pattern of frontal bone thickening with nodular growths in 4 cases (80%). Conversely, in the group of 5 donors without dementia, the presence of frontal bone thickening and nodular growth was lower (20%, n=1). Overall, frontal lobe deformities were identified in 5 of 10 donors (50%), surpassing the documented frequency of cases in the literature.
Conclusion: This case series explores inner skull findings in 10 cadavers, 5 with documented dementia history. Noteworthy observations include frontal bone thickening and asymmetrical nodular protrusions, contributing to a distinctive presentation in 5 total cases. Remarkably, 4 cases directly linked to premorbid dementia suggest a potential connection between dementia and observed cranial changes, highlighting the diagnostic value of these findings.
Significance / Implication: The presence of HFI in observed cases raises questions about its potential association with reduced brain volume, indicating clinical significance in degenerative brain processes. While the direct link to patients' outcomes is unclear, documented dementia suggests an impact on quality of life. HFI might contribute to dementia symptoms in 4 of 5 diagnosed cases, whereas suspected HFI was in only 1 of 5 undiagnosed cases. Disseminating this report aims to provide insights for clinicians when evaluating HFI patients, emphasizing the need for further research to advance our understanding of cranial morphology and neurodegenerative conditions, potentially shaping future diagnostic and therapeutic strategies for enhanced patient care.
