Hypertensive encephalopathy and hypertrophic olivary degeneration

Discussion:

This patient has long-standing and well-documented difficult to control hypertension. The distribution of microhemorrhages is characteristic of hypertension, matching the distribution of larger hemorrhage. The prior left cerebellar hemisphere hemorrhage, involving the left dentate nucleus, is the cause of the right sided hypertrophic olivary degeneration (HOD). 

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