Background: Hypertrophic olivary degeneration (HOD) is a pathological phenomenon that occurs after injury to the dentato-olivary pathway. Its hallmarks include hypertrophy of the olive with increased T2 signal intensity on magnetic resonance imaging, and it often manifests with palatal tremor and oscillopsia clinically.
Method: We report the cases of four patients who developed delayed HOD after surgical resection of pontine lesions.
Findings: We discuss the anatomical and pathological details of this disease and review the few other reported cases of HOD after resection of lesions within the brainstem.
Conclusions: HOD should be recognized as a possible complication of surgery within the brainstem and must be diagnosed promptly so that patients can be appropriately counseled and symptoms can be treated.