Heterotopic ossification (HO) is the abnormal, non-neoplastic presence of lamellar bone in soft tissue. The ectopic formation of lamellar bone in non-osseus tissues secondary to traumatic injuries of the spinal cord or the brain is defined as Neurogenic HO. The pathophysiology of HO is not clear. But several theories like overactive humoral mechanisms after fracture healing, imbalance of pro-osteoinductive and anti-osteoinductive mediators located on the soft tissues and gene mutations in such as bone morphogenetic proteins-4 (BMP-4) are proposed. Casualty factors leading to increased risk of HO include older age, blast mechanism of injury, location of injury and traumatic brain injury. The aim of this paper is to demonstrate a case of HO located in the brain without history of trauma or any other risk factors.
Citta-Pietrolungo, T.J., Alexander, M.A. and Steg, N.L. (1992) Early Detection of Heterotopic Ossification in Young Patients with Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 73, 258-262.
[3]
Garland, D.E. (1991) A Clinical Perspective on Common Forms of Acquired Heterotopic Ossification. Clinical Orthopaedics and Related Research, 263, 13-29. http://dx.doi.org/10.1097/00003086-199102000-00003
[4]
Bidner, S.M., Rubins, I.M., Desjardins, J.V., Zukor, D.J. and Goltzman, D. (1990) Evidence for a Humoral Mechanism for Enhanced Osteogenesis after Head Injury. Journal of Bone and Joint Surgery, 72, 1144-1149.
[5]
Cipriano, C.A., Pill, S.G. and Keenan, M.A. (2009) Heterotopic Ossification Following Traumatic Brain Injury and Spinal Cord Injury. Journal of the American Academy of Orthopaedic Surgeons, 17, 689-697.
[6]
Chao, S.T., Joyce, M.J. and Suh, J.H. (2007) Treatment of Heterotopic Ossification. Orthopedics, 30, 457-466.
[7]
Sakellariou, V.I., Grigoriou, E., Mavrogenis, A.F., Soucacos, P.N. and Papagelopoulos, P.J. (2012) Heterotopic Ossification Following Traumatic Brain Injury and Spinal Cord Injury: Insight into the Etiology and Pathophysiology. Journal of Musculoskeletal & Neuronal Interactions, 12, 230-240.
[8]
Iorio, R. and Healy, W.L. (2002) Heterotopic Ossification after Hip and Knee Arthroplasty: Risk Factors, Prevention and Treatment. Journal of the American Academy of Orthopaedic Surgeons, 10, 409-416.
[9]
Chalmers, J., Gray, D.H. and Rush, J. (1975) Observations on the Induction of Bone in Soft Tissues. Journal of Bone and Joint Surgery (British Volume), 57, 36-45.
[10]
Ranganathan, K., Loder, S., Agarwal, S., Wong, V.C., Forsberg, J., Davis, T.A., et al. (2015) Heterotopic Ossification: Basic-Science Principles and Clinical Correlates. Journal of Bone and Joint Surgery (American Volume), 97, 1101- 1111. http://dx.doi.org/10.2106/JBJS.N.01056
[11]
Parikh, J., Hyare, H. and Saifuddin, A. (2002) The Imaging Features of Post-Traumatic Myositis Ossificans, with Emphasis on MRI. Clinical Radiology, 57, 1058-1066. http://dx.doi.org/10.1053/crad.2002.1120
[12]
Hanquinet, S., Ngo, L., Anooshiravani, M., Garcia, J. and Bugmann, P. (1999) Magnetic Resonance Imaging Helps in the Early Diagnosis of Myositis Ossificans in Children. Pediatric Surgery International, 15, 287-289.
http://dx.doi.org/10.1007/s003830050580
[13]
Edwards, D.S. and Clasper, J.C. (2014) Heterotopic Ossification: A Systematic Review. Journal of the Royal Army Medical Corps, 161, 315-321. http://dx.doi.org/10.1136/jramc-2014-000277
[14]
Gribsholt, S.B., Stochholm, K., Mosekilde, L. and Vestergaard, P. (2014) Heterotopic Ossification in the Brain Can Occur without Preceding Trauma. Ugeskr Laeger, 176, 1411-1412.
