Hypertrophic Olivary Degeneration š§
Lesions that disrupt the triangle of Guillain and Mollaret (neural pathway connecting the red nucleus, inferior olivary nucleus, and contralateral dentate nucleus) can result in swollen inferior olivary nuclei
#Neurosurgery #neurology @RSNA
Lesions that disrupt the triangle of Guillain and Mollaret (neural pathway connecting the red nucleus, inferior olivary nucleus, and contralateral dentate nucleus) can result in swollen inferior olivary nuclei
#Neurosurgery #neurology @RSNA
Clinical: Classic presentation is palatal myoclonus (involuntary movement of soft palate, uvula and pharynx)
Imaging: T2/FLAIR bright and swollen inferior olivary nuclei w/o enhancement
š” Can be unilateral or bilateral if a lesions disrupts both pathways of the GMT
Imaging: T2/FLAIR bright and swollen inferior olivary nuclei w/o enhancement
š” Can be unilateral or bilateral if a lesions disrupts both pathways of the GMT
š” Lesions at the midbrain pontine junction can disrupt both the ipsilateral central tegmental tract and contralateral dentorubral tract leading to bilateral HOD
1st case shows HOD 2/2 a remote hemorrhage of the left midbrain/pons extending into superior cerebellar peduncle
1st case shows HOD 2/2 a remote hemorrhage of the left midbrain/pons extending into superior cerebellar peduncle
2nd case shows bilateral non-lesional HOD
š” Be aware of HOD to avoid misdiagnosis of tumor, demyelination, etc.
š” Patients may develop palatal myoclonus
radiopaedia.org
š” Patients may develop palatal myoclonus
radiopaedia.org
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