Images in Neurology |

Hyperostosis Frontalis Interna

Andrew J. Waclawik, MD
Arch Neurol. 2006;63(2):291. doi:10.1001/archneur.63.2.291.
Text Size: A A A
Published online


An 85-year-old woman underwent a head magnetic resonance imaging scan for evaluation of progressive gait difficulty and memory decline. Her examination findings showed marked short-term memory problems and postural instability with mild extrapyramidal signs. She had a history of chronic hypertension but no history of any endocrinopathy. She was receiving diltiazem, hydralazine, and sertraline. Blood laboratory test results showed no significant abnormalities.

Brain magnetic resonance images showed severe thickening of the inner table of the skull, with prominent bone lobulations in the frontal regions (Figure), typical of hyperostosis frontalis interna (HFI). She also had severe, diffuse small-vessel ischemic changes, most severe in the bilateral basal ganglia regions (not shown), which probably were the cause of her gait instability, extrapyramidal signs, and memory problems.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

Sagittal (A) and axial (B) T1-weighted images showing severe, bilateral thickening and lobulation of the inner bone table in the frontal skull regions.

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Topics
PubMed Articles