Hypertrophic Olivary Degeneration and Cerebrovascular Disease: Movement in a Triangle

Santos, Ana Filipa; Rocha, Sofia; Varanda, Sara; Pinho, João; Rodrigues, Margarida; Fontes, João Ramalho; Soares-Fernandes, João; Ferreira, Carla

doi:10.1016/j.jstrokecerebrovasdis.2014.09.036

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…The typical palatal tremor and vertical nystagmus were largely asymptomatic but he was mainly burdened by the gait ataxia and by the development of postural and action tremor suggestive of Holmes tremor. The clinical course with initial improvement after the brainstem haemorrhage followed by insidious secondary deterioration is similar to other reported cases of HOD (13)(14)(15).…”

Section: Discussionsupporting

confidence: 87%

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Hypertrophic Olivary Degeneration After Brainstem Haemorrhage – A Case Report

Radu¹,

Ionita²,

Terecoasa³

et al. 2019

Ro J Neurol.

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Insidious neurological deterioration may develop months to years after a lesion involving the Guillain-Mollaret triangle due to hypertrophic olivary degeneration. Lesions involving the dento-rubro-olivary pathways may lead to pseudo-hypertrophy of the inferior olivary nucleus with subsequent neuronal degeneration. A number of clinical syndromes have been linked to hypertrophic olivary degeneration. Cases of gait ataxia, Holmes tremor and symptomatic palatal and oculo-palatal tremor were associated with this condition. We hereby report a case of disabling Holmes tremor and gait ataxia associated with palatal tremor in a 45-year-old patient with a prior brainstem haemorrhage.

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Section: Discussionsupporting

confidence: 87%

“…Many of the reported cases developed signs and symptoms suggestive of HOD more than one year after the initial lesion and so did our patient (13)(14)(15)(16). Neuropathological and imaging abnormalities are reported early after the initial lesion.…”

Section: Discussionsupporting

confidence: 51%

Hypertrophic Olivary Degeneration After Brainstem Haemorrhage – A Case Report

Radu¹,

Ionita²,

Terecoasa³

et al. 2019

Ro J Neurol.

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“…HOD is an unusual type of neuronal degeneration in that it results in neuronal hypertrophy, as opposed to atrophy, which is the most common type of neuronal degeneration seen in other synaptic circuits [9,11,12]. Multiple factors that affect the dentato-rubro-olivary tract have been identified as causes of HOD, including hemorrhage, neoplasms, trauma, demyelination, inflammation, radiation damage, surgical manipulation, and idiopathic nature [13][14][15][16][17][18][19]. The hypertrophy is believed to be the result of disruption of the γaminobutyric acid (GABA)-ergic inhibitory effects of the RN over the ION [20], which subsequently leads to neuronal vacuolar necrosis, myelin loss, and gliosis [13].…”

Section: Discussionmentioning

confidence: 99%

Temporal Evolution of Hypertrophic Olivary Degeneration in a Pediatric Patient: A Case Report and Review of Literature

Torres

Vicenty-Padilla

Cay-Martínez

et al. 2020

Cureus

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Hypertrophic olivary degeneration (HOD) is a rare type of neuronal degeneration seen after interruption of the dentato-rubro-olivary tract also known as the Guillain-Mollaret triangle (GMT). It is associated with hypertrophic changes of the inferior olive. Commonly reported in adults, this lesion presents with ataxia and oculopalatal myoclonus. Up to date, few cases have been published in the literature that refer to pediatric cases. This diagnosis is particularly important in the setting of brainstem tumor surgery as it should not be confused for tumor recurrence or metastasis, in turn avoiding unwarranted surgical intervention. We present the case of a 15-year-old male who underwent resection of a left superior cerebellar peduncle (SCP) pilocytic astrocytoma. On follow-up, magnetic resonance imaging (MRI) demonstrated evidence of mild residual tumor as well as progressive engorgement of the inferior olivary nucleus (ION). The patient was clinically asymptomatic and has since been observed expectantly without any issues. We were able to pinpoint the most probable location of injury in our patient's GMT. HOD remains a somewhat obscure entity. Its presentation may be early and not accompanied by significant neurologic findings, in contrast to what has been previously reported. Particularly in neoplastic cases, it may represent a diagnostic challenge and could be easily confused for tumor recurrence. A multidisciplinary approach for this entity, as with other pathologies, is of particular importance. Its proper recognition will result in the best outcomes for the patient.

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“…It has also been reported that many factors can affect the dento-rubro-olivary pathway, such as surgical operation, hemorrhage, tumor, trauma, inflammation, demyelination, degeneration, and radiation damage. 5 – 8 In a recent study, we can see the etiology, clinical manifestation, MRI presentation, and prognosis of HOD clarified in detail. 9 Although the theory of the triangle of Guillain and Mollaret has been described, diagnosing HOD following resection of cavernomas of the brain stem by using diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) has not been reported.…”

Section: Introductionmentioning

confidence: 99%

A case of hypertrophic olivary degeneration after resection of cavernomas of the brain stem and review of the literature

Zhang¹,

Ye²,

Deng³

et al. 2015

NDT

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Hypertrophic olivary degeneration is a transsynaptic form of degeneration, which is also a result of primary or secondary lesion and can damage the dento-rubro-olivary pathway. The dento-rubro-olivary pathway was first described by Guillain and Mollaret and is referred to as “the triangle of Guillain and Mollaret”. Multiple factors can destroy the dento-rubro-olivary pathway, such as surgical operation, hemorrhage, tumor, trauma, inflammation, demyelination, degeneration, and radiation damage. All of the above factors can result in delayed hypertrophic olivary degeneration. Articles related to this disease cover etiology, clinical presentation, pathology changes, etc. However, to our knowledge, there has been no literature reporting the use of diffusion tensor imaging and diffusion tensor tractography to improve the diagnosis of hypertrophic olivary degeneration following resection of cavernomas in the brain stem. Herein, we report a case who was diagnosed with hypertrophic olivary degeneration following resection of cavernomas of the brain stem, verify the significance of diffusion tensor imaging and diffusion tensor tractography, and review previous literature. The development of imageology promotes and improves hypertrophic olivary degeneration diagnosis and differential diagnosis.

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Hypertrophic Olivary Degeneration and Cerebrovascular Disease: Movement in a Triangle

Cited by 7 publications

References 5 publications

Hypertrophic Olivary Degeneration After Brainstem Haemorrhage – A Case Report

Hypertrophic Olivary Degeneration After Brainstem Haemorrhage – A Case Report

Temporal Evolution of Hypertrophic Olivary Degeneration in a Pediatric Patient: A Case Report and Review of Literature

A case of hypertrophic olivary degeneration after resection of cavernomas of the brain stem and review of the literature

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