Diffusion Tensor Imaging in a Case of Pontine Bleeding Showing Hypertrophic Olivary Degeneration and Cerebellar Ataxia

Abstract

We present diffusion tensor tractography (DTT) findings in a case of hypertrophic olivary degeneration (HOD) and cerebellar ataxia. A 56-year-old man presented with abnormal ataxic gait and dysarthria. MRI 5 months after onset showed chronic pontine hematoma and enlarged bilateral inferior olivary nuclei. DTT showed decreased volume of the bilateral central tegmental tract, in accordance with the conventional hypothesis that HOD is associated with neurologic insult to the Guillain-Mollaret triangle. The patient’s cerebellar ataxia was speculated to be due to decreased decussating fibers of the superior cerebellar peduncle, and this was confirmed by DTT.

Unilateral Dorsolateral Medullary Hemorrhage Presenting with Severe Dysphagia

“…MRA conducted at the same time again did not reveal any vascular anomaly or tumor. Diffusion tensor tractography, performed on the same day (40th hospital day) as the second MRI using our previously reported technique [ 4 ], showed a decreased volume of the right cortico-mesencephalic tract (Fig. 3 ).…”

Multicenter Prospective Analysis of Hypertrophic Olivary Degeneration Following Infratentorial Stroke (HOD-IS): Evaluation of Disease Epidemiology, Clinical Presentation, and MR-Imaging Aspects

“…Advanced imaging techniques have been sporadically applied in HOD patients in this regard to visualize fiber tracts associated with HOD development. Diffusion tensor imaging (DTI) with tractography can be used to analyze the change in fiber tract volume following injury in the GMT (14)(15)(16). The use of this method systematically to investigate the HOD development and more precisely understand the injury to brainstem connectivity is promising beyond merely pinpointing down a lesion to an anatomic localization on MRI or in ex-vivo pathological studies.…”