Dr. Juan Torres; Guatemala; Myositis Ossificans and Hydrocephalus

SUMMARY: Dr. Torres, Head of Neurosurgery in the Bautista Children's Hospital in Managua Nicaragua, reports on a young patient with a previous diagnosis of Myositis Ossificans, who developed hydrocephalus, that was complicated to treat. Myositis Ossificans is a rare genetic form of the disease which consists of calcification being deposited in tissues during the healing process. He describes the genetic defect. Dr. Torres' patient developed acute hydrocephalus, had an ETV placed and recovered only to return in 3 months with raised ICP. A VP shunt was placed which failed in 2 days for non absorption of CSF and a new ETV was planned but her ventricle size returned to normal and the procedure was not done. 4 months later the patient returned with Hydrocephalus and a new ETV was done.  Only three cases are reported with hydrocephalus in a literature search with little detail. Dr. Torres proposes from this experience that an ETV would be the treatment of choice in these rare cases. The discussion was about the treatment of complicated hydrocephalus. Is the hydrocephalus a manifestation of Myosisits  Ossiifiicans  or independent of the disease?                                                           (JIA)

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