Imaging differentials

• hyperostosis frontalis interna
• calcified old subdural hemorrhage

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.