Hyperostosis frontalis interna | 您所在的位置:网站首页 › radiopaediaorg › Hyperostosis frontalis interna |
Hyperostosis frontalis interna is characterized by benign overgrowth of the inner table of the frontal bone. The etiology is unknown. The condition is generally of no clinical significance and an incidental finding. It is typically bilateral and symmetrical and may extend to involve the parietal bones. The skull thickening may be sessile or nodular, and may affect the bone in a focal or diffuse manner. The importance of this condition stems mainly from the necessity of not mistaking it for pathology (see below). Hyperostosis calvariae diffusa and hyperostosis frontoparietalis are related entities. On this page: Article: Epidemiology Clinical presentation Pathology Classification History and etymology Associations Differential Diagnosis References Images:Cases and figures EpidemiologyPost mortem studies report a prevalence of 12% 3. 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. Clinical presentationAs hyperostosis frontalis interna is usually an incidental finding of no clinical significance patients are generally asymptomatic. Compression by calvarial thickening may lead to cerebral atrophy and may present with cognitive impairment, neuropsychiatric symptoms, headaches and epilepsy 1,3. ADVERTISEMENT: Supporters see fewer/no ads PathologyThe etiology and pathogenesis are not well understood although many theories have been proposed. 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. ClassificationHyperostosis frontalis interna is classified into four grades of severity based on Hershkovitz's morphological and histopathological findings 1. 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. type A: endocranial frontal bone elevations less than 10 mm in diameter type B: nodular bony formations occupying less than 25% of the frontal bone type C: nodular bony formations occupying up to 50% of the frontal bone type D: continuous nodular bony formations involving more than 50% of the frontal endocranium type E: severe hyperostosis frontalis interna with soft tissue expansionADVERTISEMENT: Supporters see fewer/no ads History and etymologyIt was first described in 1719 by Morgagni as a pathology accompanying virilism and obesity 3. AssociationsIt is part of the triad of Morgagni syndrome and may be encountered in a number of other syndromes 3: Troell-Junet syndrome Frölich syndrome Klippel-Trénaunay-Weber syndrome Differential DiagnosisThe differential is that of hyperostosis of the skull and includes: Paget disease fibrous dysplasia sclerotic metastases meningioma acromegaly bone marrow pathology |
CopyRight 2018-2019 实验室设备网 版权所有 |