This was the initial sketch I came up with when we writers were putting our heads together, trying to come up with inventive bad guys for HANNIBAL. I had this idea of a guy in a suit using a dire wolf skull strapped to his head to eviscerate his adversaries -- in stark contrast to the title character's own neat, urbane method of killing.
For the picture, I started with an old phrenology chart for the human head and added the wolf jaws (cave bear jaws in the episode -- bigger, chompier...) to it. Colored and "dirtied" it up to make it seem more old-world.
And yes, dire wolves were real creatures that roamed the earth once upon a time...