Hypertrophic olivary degeneration after surgical removal of cavernous malformations of the brain stem: report of four cases and review of the literature

Acta Neurochir (Wien). 2008 Feb;150(2):149-56; discussion 156. doi: 10.1007/s00701-007-1470-0. Epub 2008 Jan 2.


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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Central Nervous System Vascular Malformations / surgery*
  • Female
  • Humans
  • Hypertrophy / etiology
  • Male
  • Middle Aged
  • Olivary Nucleus / pathology*
  • Postoperative Complications*