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Alvarez L, Corrigan W, McGonegal C, Leon J, Avila D, Kane F, Lee T. The clinical manifestations of hyperostosis frontalis interna: A qualitative systematic review of cases. Clin Anat 2024; 37:505-521. [PMID: 38420744 DOI: 10.1002/ca.24147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 02/03/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
Hyperostosis frontalis interna (HFI) is a condition defined as abnormal bone growth on the posterior aspect of the frontal bone. Despite uncertainties regarding its etiology and prognosis, clinicians typically consider HFI a benign pathology. There are no studies organizing all the possible manifestations of the disease. The present study aims to organize all the clinical manifestations of HFI within the current case report/series literature. A blinded PRISMA-guided search of HFI case reports and case series yielded 43 relevant articles and provided 110 patients for analysis. The symptoms presenting alongside HFI were extracted and tabulated. We found high-frequency clinical manifestations of HFI (>20% of patients) to include headaches, obesity, vertigo/dizziness symptoms, cognitive decline, and depression. An additional 15 symptoms were tabulated at frequencies found to be less than 20%. Based on our analysis, we suggest the constellation of high-frequency symptoms can offer a more comprehensive clinical picture of symptomatic HFI which may be valuable to consider for clinicians and future researchers in the field of HFI.
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Affiliation(s)
| | | | | | - Jimmy Leon
- Advent Health Sebring, Sebring, Florida, USA
| | | | | | - Tracey Lee
- Advent Health Sebring, Sebring, Florida, USA
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Szeniczey T, Marcsik A, Ács Z, Balassa T, Bernert Z, Bakó K, Czuppon T, Endrődi A, Évinger S, Farkas Z, Hlavenková L, Hoppál K, Kálmán Kiss C, Kiss K, Kocsis K, Kovács LO, Kovács PF, Köhler K, Költő L, Kővári I, László O, Lovász G, Lovranits J, Lukács J, Masek Z, Merczi M, Molnár E, Németh CE, Ódor JG, Paja L, Pap I, Patay R, Rácz I, Rácz Z, Ritoók Á, Szenthe G, Szilas G, Szőke BM, Tóth Z, Vida T, Wolff K, Finnegan M, Hajdu T. Hyperostosis frontalis interna in ancient populations from the Carpathian Basin - A possible relationship between lifestyle and risk of development. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:108-118. [PMID: 30342349 DOI: 10.1016/j.ijpp.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The prevalence of hyperostosis frontalis interna (HFI) was examined in different periods of the Carpathian Basin from 4900 BCE to 17th century AD. The study seeks to evaluate temporal changes in HFI and the possible impact of lifestyle on it. MATERIALS The studied material consisted of 4668 crania from Hungary and Serbia. METHODS The crania were analyzed employing macroscopic and endoscopic examination. RESULTS In historic periods, sex and age played a pivotal role in HFI development. Among predominantly pastoralist populations of the 5th-8th and 10th centuries, prevalence of HFI was considerably higher than in the medieval populations of the 9th-17th centuries. CONCLUSIONS In addition to age and sex, other factors could be implicated in HFI development. The physiological effects of the pastoralist lifestyle and diet on insulin regulation could explain the increased risk of developing HFI in the 5th-8th and 10th-century populations. SIGNIFICANCE The study provides the first comprehensive dataset of HFI from different archaeological periods from the Carpathian Basin. It has implications for lifestyle and risk of HFI development in past populations. LIMITATIONS The archaeological periods are not equally represented. SUGGESTIONS FOR FURTHER RESEARCH In order to better understand the etiology of HFI, lifestyle factors can be used to elucidate the risk of developing HFI in ancient populations.
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Affiliation(s)
- Tamás Szeniczey
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary.
| | - Antónia Marcsik
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - Zsófia Ács
- Department of Archaeological Excavations and Artefact Processing, Hungarian National Museum, Budapest, H-1088, Hungary
| | | | - Zsolt Bernert
- Department of Anthropology, Hungarian Natural History Museum, Budapest, H-1083, Hungary
| | - Katalin Bakó
- Budavári Ingatlanfejlesztő és Üzemeltető Nonprofit Ltd., Budapest, H-1013, Hungary
| | | | - Anna Endrődi
- Department of Prehistoric and Migration Period, Budapest History Museum, Aquincum Museum and Archaeological Park, H-1014, H-1031, Budapest, Hungary
| | - Sándor Évinger
- Department of Anthropology, Hungarian Natural History Museum, Budapest, H-1083, Hungary
| | | | - Lucia Hlavenková
- Institute for History of Medicine and Foreign Languages, Charles University, Prague, 121 08, Czech Republic
| | - Krisztina Hoppál
- Silk Road Research Group, Hungarian Academy of Sciences-Eötvös Loránd University-Szeged University, Budapest, Hungary
| | | | - Krisztián Kiss
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary
| | - Kinga Kocsis
- Roska Tamás Doctoral School of Sciences and Technology, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, H-1083, Hungary; Neuronal Network and Behavior Research Group, Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, H-1117, Hungary
| | - Loránd Olivér Kovács
- Department of Archaeological Excavations and Artefact Processing, Hungarian National Museum, Budapest, H-1088, Hungary
| | | | - Kitti Köhler
- Institute of Archaeology, Research Centre for the Humanities, Hungarian Academy of Sciences, Budapest, H-1097, Hungary
| | | | - Ivett Kővári
- International Committee of the Red Cross, Geneva, 1202, Switzerland
| | - Orsolya László
- Archaeological Heritage Directorate, Hungarian National Museum, Budapest, H-1113, Hungary
| | | | - Júlia Lovranits
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - József Lukács
- Budavári Ingatlanfejlesztő és Üzemeltető Nonprofit Ltd., Budapest, H-1013, Hungary
| | - Zsófia Masek
- Institute of Archaeology, Research Centre for the Humanities, Hungarian Academy of Sciences, Budapest, H-1097, Hungary
| | | | - Erika Molnár
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - Csilla Emese Németh
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, H-1094, Hungary
| | | | - László Paja
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - Ildikó Pap
- Department of Anthropology, Hungarian Natural History Museum, Budapest, H-1083, Hungary
| | - Róbert Patay
- Ferenczy Museum Center, Szentendre, H-2000, Hungary
| | - István Rácz
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary; Department of Archaeometry and Archaeological Methodology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Zsófia Rácz
- Department of Early Medieval and Historical Archaeology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Ágnes Ritoók
- Department of Archaeology, Hungarian National Museum, Budapest, H-1088, Hungary
| | - Gergely Szenthe
- Department of Archaeology, Hungarian National Museum, Budapest, H-1088, Hungary
| | - Gábor Szilas
- Department of Prehistoric and Migration Period, Budapest History Museum, Aquincum Museum and Archaeological Park, H-1014, H-1031, Budapest, Hungary
| | - Béla Miklós Szőke
- Institute of Archaeology, Research Centre for the Humanities, Hungarian Academy of Sciences, Budapest, H-1097, Hungary
| | - Zoltán Tóth
- Dobó István Castle Museum, Eger, H-3300, Hungary
| | - Tivadar Vida
- Department of Early Medieval and Historical Archaeology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Katalin Wolff
- Department of Early Medieval and Historical Archaeology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Michael Finnegan
- Department of Sociology, Anthropology and Social Work, Kansas State University, Manhattan, KS, 66506, USA
| | - Tamás Hajdu
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary.
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Bracanovic D, Djonic D, Nikolic S, Milovanovic P, Rakocevic Z, Zivkovic V, Djuric M. 3D-Microarchitectural patterns of Hyperostosis frontalis interna: a micro-computed tomography study in aged women. J Anat 2016; 229:673-680. [PMID: 27279170 DOI: 10.1111/joa.12506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/27/2022] Open
Abstract
Although seen frequently during dissections and autopsies, Hyperostosis frontalis interna (HFI) - a morphological pattern of the frontal bone thickening - is often ignored and its nature and development are not yet understood sufficiently. Current macroscopic classification defines four grades/stages of HFI based on the morphological appearance and size of the affected area; however, it is unclear if these stages also depict the successive phases in the HFI development. Here we assessed 3D-microarchitecture of the frontal bone in women with various degrees of HFI expression and in an age- and sex-matched control group, hypothesizing that the bone microarchitecture bears imprints of the pathogenesis of HFI and may clarify the phases of its development. Frontal bone samples were collected during routine autopsies from 20 women with HFI (age: 69.9 ± 11.1 years) and 14 women without HFI (age: 74.1 ± 9.7 years). We classified the HFI samples into four groups, each group demonstrating different macroscopic type or stage of HFI. All samples were scanned by micro-computed tomography to evaluate 3D bone microarchitecture in the following regions of interest: total sample, outer table, diploe and inner table. Our results revealed that, compared to the control group, the women with HFI showed a significantly increased bone volume fraction in the region of diploe, along with significantly thicker and more plate-like shaped trabeculae and reduced trabecular separation and connectivity density. Moreover, the inner table of the frontal bone in women with HFI displayed significantly increased total porosity and mean pore diameter compared to controls. Microstructural reorganization of the frontal bone in women with HFI was also reflected in significantly higher porosity and lower bone volume fraction in the inner vs. outer table due to an increased number of pores larger than 100 μm. The individual comparisons between the control group and different macroscopic stages of HFI revealed significant differences only between the control group and the morphologically most pronounced type of HFI. Our microarchitectural findings demonstrated clear differences between the HFI and the control group in the region of diploe and the inner table. Macroscopic grades of HFI could not be distinguished at the level of bone microarchitecture and their consecutive nature cannot be supported. Rather, our study suggests that only two different types of HFI (moderate and severe HFI) have microstructural justification and should be considered further. It is essential to record HFI systematically in human postmortem subjects to provide more data on the mechanisms of its development.
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Affiliation(s)
- Djurdja Bracanovic
- Laboratory for Anthropology, Department of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Radiology, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Danijela Djonic
- Laboratory for Anthropology, Department of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Slobodan Nikolic
- Institute of Forensic Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Milovanovic
- Laboratory for Anthropology, Department of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Rakocevic
- Department of Radiology, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Vladimir Zivkovic
- Institute of Forensic Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Djuric
- Laboratory for Anthropology, Department of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia.
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