Hypertrophic olivary degeneration
Diagnosis almost certain
Updates to Case Attributes
Status
changed from draft to published (unlisted).
Visibility
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Published At
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.
Body
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Hypertrophic olivary degeneration is a rare condition characterised by unique pattern of trans-synaptic degeneration. It is caused by a lesion in the triangle of Guillain and Mollaret, resulting in hypertrophy of the inferior olivary nucleus. In this case the previous haemorrhagic lesion in the right dentate nucleus caused the interruption that led to hypertrophic olivary degeneration.
- +<p><a title="Hypertrophic olivary degeneration (HOD)" href="/articles/hypertrophic-olivary-degeneration">Hypertrophic olivary degeneration</a> is a rare condition characterised by unique pattern of trans-synaptic degeneration. It is caused by a lesion in the <a href="/articles/triangle-of-guillain-and-mollaret">triangle of Guillain and Mollaret</a>, resulting in hypertrophy of the <a href="/articles/missing">inferior olivary nucleus</a>. In this case the previous haemorrhagic lesion in the right dentate nucleus caused the interruption that led to hypertrophic olivary degeneration. </p>
Diagnostic Certainty
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.
Updates to Quizquestion Attributes
Question
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Knowing that this patient had a previous haemorrhagic lesion on the area of the right cerebellar dentate nucleus, what is the most likely diagnosis for the hypersignal on T2/FLAIR at the left anterolateral aspect of the pons?
Answer
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Hypertrophic olivary degeneration.
Updates to Quizquestion Attributes
Question
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What are the three corners of the triangle of Guillain and Mollaret?
Answer
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1) red nucleus
2) inferior olivary nucleus
3) contralateral dentate nucleus
Updates to Quizquestion Attributes
Answer
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Interruption of either of the connections between the dentate nucleus and contralateral red nucleus (dentatorubral tract, superior cerebellar peduncle) or the connection between the red nucleus and ipsilateral inferior olivary nucleus (central tegmental tract) leads to changes in the olive.
Question
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What is the cause for hypertrophic olivary degeneration?
Updates to Study Attributes
Modality
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Annotated image.
Findings
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Rounded T2/FLAIR hyperintensity in the left inferior pons. This is consistent with hypertrophic olivary degeneration related to a contralateral dentate nucleus lesion.
Images Changes:
Image Annotated image (Axial T2 and FLAIR) ( update )
Perspective
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Axial T2 and FLAIR.
Image 1 Annotated image (Axial T2 and FLAIR) ( create )