Hypertrophic olivary degeneration: case report in a child

Abstract

We report a case of hypertrophic olivary degeneration (HOD) detected by MRI, in a 14-year-old girl, 13 months after surgical excision of a brainstem cavernous malformation. As in vivo diagnosis of this condition has only become possible with the advent of MRI, the number of reported cases remains relatively small and they are almost exclusively in adults. Many radiologists and particularly paediatric radiologists, may therefore be unfamiliar with this entity. To our knowledge, this is the first specific report of HOD diagnosed by MRI in a child.

Hypertrophic olivary degeneration in children: four new cases and a review of the literature with an emphasis on the MRI findings

“…Midline lesions or lesions in the brachium conjunctivum (superior cerebellar peduncle), finally interrupting decussation of the DROP, can result in bilateral HOD [3,5]. Our small paediatric series is distinguished from the previous studies in that all cases presented with bilateral HOD.…”

“…The superior cerebellar peduncle provides connection between the ipsilateral red and the contralateral dentate nuclei, while the inferior cerebellar peduncle links the contralateral dentate and the ipsilateral and inferior olivary nuclei and makes the other edges of the triangle (Figure 1) [3][4][5]. Lesions deafferating the olive (in the dentato-rubral or rubro-olivary pathway) can result in HOD more frequently than lesions of the olivodentate pathway [6].…”

“…In all cases except the idiopathic one, surgeryrelated injuries were present. This aetiological frequency differs in the adult population, in which ischaemic lesions (most often along with haemorrhage) are the leading cause [5]. Although neuronal loss and glial proliferation typically follow tissue damage in the CNS, degeneration of the ION occurs with hypertrophy [3,5,10].…”

Bilateral hypertrophic olivary nucleus degeneration on magnetic resonance imaging in children with Leigh and Leigh-like syndrome

“…20 In addition, the reports on hypertrophic olivary degeneration in paediatric patients are limited. 15,[25][26][27] In this report, we sought to analyse whether bilateral symmetrical inferior olivary nucleus hypertrophy is specifically associated with mitochondrial disorders in children.…”

Hypertrophic olivary degeneration in a child following midbrain tumor resection: longitudinal diffusion tensor imaging studies

“…7 In children, disruptive lesions of the GMT may include low-and high-grade tumors and vascular malformations. 10,12,14,16,21 Neurophysiologically, this causes the removal of inhibition of the electrotonic gap junctions in the inferior olivary nucleus. 3,18 On histopathology, disinhibition and deafferentation of the inferior olivary nucleus result in vacuolar degeneration and enlargement of neurons and an increase in glial cells and hypertrophy of astrocytes.…”