• Jared S Rosenblum, Matt Nazari, Yasir Al-Khalili, Valeria Potigailo, and Erol Veznedaroglu.
• Department of Neurosurgery, Drexel Neurosciences Institute, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA. Electronic address: jrosenblum2@bwh.harvard.edu.
• World Neurosurg. 2018 Feb 1; 110: 294-300.

BackgroundHypertrophic olivary degeneration (HOD) is a rare phenomenon in the dento-rubro-olivary pathway caused by lesion or disruption of the fibers of the Guillain-Mollaret triangle. Hemorrhage of pontine and midbrain cavernous angiomas can rarely lead to HOD portending neurologic deterioration and possible concomitant life-threatening complications; for this reason, it may define a poignant consideration in planning intervention.Case DescriptionThe patient was a 57-year-old woman with known midbrain-pontine cavernous angioma. For several years, the lesion had been stable, as shown by imaging follow-up, until 10 months before the patient presented with falls, dysarthria, and headache. Imaging showed some decrease in size as well as blood product around the cavernous angioma, suggesting interim period hemorrhage and interval development of HOD.ConclusionsThe literature regarding imaging recommendations for stable cavernous angioma in the midbrain-pontine junction is reviewed. The implication of HOD for patient outcome is discussed and a comment is made on how the development of HOD may affect management of the cavernous angioma.Copyright © 2017 Elsevier Inc. All rights reserved.

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