Presentation
Headache for several years. Vertigo for few days. Hypertension, diabetes. Deviated nasal septum.
Patient Data
Sheet-like calcific density along inner surface of frontal bone, limited on each side by coronal suture. The calcification is discrete from inner table of the cranium.
Calcification also noted in anterior falx cerebri.
Mastoid air cells reduced and sclerosed with inner fluid collections on both sides.
Case Discussion
Imaging differentials
The entire inner table and diploic space of the frontal bone is clearly delineated, without any lobulation or thickening — excluding hyperostosis frontalis.
The calcification is limited on both sides by the coronal suture — excluding subdural location.
Meningioma and dural osteoma are remote considerations due to the very thin sheet-like configuration of the calcification, and also due to the discrete bony margin of the inner table.
The calcification in this patient is most likely an incidental finding, and may be attributed to physiologic aging process along with the falx calcification. However, in presence of other supporting evidences (e.g. punched-out lesions, hair-on-end or pepper-pot appearance), hyperparathyroidism (primary/secondary/tertiary) would merit consideration.
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