Abstract
We report a case of hypertrophic olivary degeneration due to cerebellar surgery for a low-grade tumor. A 27-year-old female presented with right-sided paresthesias and intermittent leg paresis following a right cerebellar resection of a tumor 2 weeks prior. One month later, her symptoms remained stable while her neurological examination demonstrated slight right hemi-body hypoesthesia and subtle appendicular ataxia in her right upper extremity. An MRI scan revealed a hypertrophied left anterolateral medulla with increased T2 signal and no diffusion abnormality. The T2 hyperintensity and hypertrophy slowly resolved and she clinically improved without further intervention. Hypertrophic olivary degeneration may be mistaken for tumor progression, post-operative vasculopathy or granulation tissue and should be considered in patients undergoing cerebellar surgery.
Similar content being viewed by others
References
Kitajima M, Korogi Y, Shimomura O et al (1994) Hypertrophic olivary degeneration: MR imaging and pathologic findings. Radiology 192:539–543
Salamon-Murayama N, Russell EJ, Rabin BM (1999) Diagnosis please. Case 17: hypertrophic olivary degeneration secondary to pontine hemorrhage. Radiology 213:814–817
Tsui EY, Cheung YK, Mok CK et al (1999) Hypertrophic olivary degeneration following surgical excision of brainstem cavernous hemangioma: a case report. Clin Imaging 23:215–217
Krings T, Foltys H, Meister IG et al (2003) Hypertrophic olivary degeneration following pontine haemorrhage: hypertensive crisis or cavernous haemangioma bleeding? J Neurol Neurosurg Psychiatry 74:797–799
Rieder CR, Reboucas RG, Ferreira MP (2003) Holmes tremor in association with bilateral hypertrophic olivary degeneration and palatal tremor: chronological considerations. Case report. Arq Neuropsiquiatr 61:473–477
Conforto AB, Smid J, Marie SK et al (2005) Bilateral olivary hypertrophy after unilateral cerebellar infarction. Arq Neuropsiquiatr 63:321–323
Uchino A, Hasuo K, Uchida K et al (1993) Olivary degeneration after cerebellar or brain stem haemorrhage: MRI. Neuroradiology 35:335–338
Harter DH, Davis A (2004) Hypertrophic olivary degeneration after resection of a pontine cavernoma. Case illustration. J Neurosurg 100:717
Phatouros CC, McConachie NS (1998) Hypertrophic olivary degeneration: case report in a child. Pediatr Radiol 28:830–831
Goyal M, Versnick E, Tuite P et al (2000) Hypertrophic olivary degeneration: metaanalysis of the temporal evolution of MR findings. AJNR Am J Neuroradiol 21:1073–1077
Kim SJ, Lee JH, Suh DC (1994) Cerebellar MR changes in patients with olivary hypertrophic degeneration. AJNR Am J Neuroradiol 15:1715–1719
Goto N, Kaneko M (1981) Olivary enlargement: chronological and morphometric analyses. Acta Neuropathol (Berl) 54:275–282
Hanihara T, Amano N, Takahashi T et al (1998) Hypertrophy of the inferior olivary nucleus in patients with progressive supranuclear palsy. Eur Neurol 39:97–102
Nishie M, Yoshida Y, Hirata Y et al (2002) Generation of symptomatic palatal tremor is not correlated with inferior olivary hypertrophy. Brain 125:1348–1357
Dubinsky RM, Hallett M, Di Chiro G et al (1991) Increased glucose metabolism in the medulla of patients with palatal myoclonus. Neurology 41:557–562
Shepherd GM, Tauboll E, Bakke SJ et al (1997) Midbrain tremor and hypertrophic olivary degeneration after pontine hemorrhage. Mov Disord 12:432–437
Gordon N (2007) The cerebellum and cognition. Eur J Paediatr Neurol 11:232–234
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Akar, S., Drappatz, J., Hsu, L. et al. Hypertrophic olivary degeneration after resection of a cerebellar tumor. J Neurooncol 87, 341–345 (2008). https://doi.org/10.1007/s11060-008-9523-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-008-9523-7