IMAGES IN NEUROLOGY N 85-YEAR -OLD Hyperostosis frontalis interna is hormonal influences on bone growth woman underwent a an abnormality of the inner table of in the skull have been postulated. head magnetic reso- the frontal bones of the skull con- Most frequently, however, HFI is an nance imaging scan sisting of typically smooth, rounded incidental finding and by itself is not A for evaluation of pro- enostoses covered by dura and pro- indicative of any disease. gressive gait difficulty and memory jecting into the cranial cavity. These Andrew J. Waclawik, MD decline. Her examination findings enostoses are typically less than 1 cm showed marked short-term memory thick; therefore, the HFI observed in Accepted for Publication: April 18, problems and postural instability our patient was unusually severe. with mild extrapyramidal signs. She Hyperostosis frontalis interna is Correspondence: Dr Waclawik, had a history of chronic hyperten- typically an incidental finding on Department of Neurology, CSC H6/ sion but no history of any endocri- plain x-ray films, computed tomog- 574, University of Wisconsin nopathy. She was receiving diltia- raphy, or magnetic resonance im- Medical School, 600 Highland Ave, zem, hydralazine, and sertraline. ages of the head. It has been re- Madison, WI 53792 (waclawik Blood laboratory test results showed ported in 5% to 12% of the general @neurology.wisc.edu). no significant abnormalities. population, but is more common in Brain magnetic resonance elderly patients and postmeno- images showed severe thickening pausal women, especially when as- REFERENCES 2,3 of the inner table of the skull,...