Temporal Evolution of Hypertrophic Olivary Degeneration in a Pediatric Patient: A Case Report and Review of Literature
| Autor: | Juan C. Vicenty-Padilla, Karla C. Cay-Martinez, Michael Ortiz Torres, Eduardo J. Labat, Juan Vigo-Prieto |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Ataxia hypertrophic olivary degeneration Neurosurgery 030204 cardiovascular system & hematology Asymptomatic Metastasis Lesion 03 medical and health sciences 0302 clinical medicine medicine Inferior olivary nucleus pilocytic astrocytoma medicine.diagnostic_test Pilocytic astrocytoma business.industry General Engineering Magnetic resonance imaging Olivary degeneration medicine.disease guillain-mollaret triangle dentato-rubro-olivary tract pediatric Medical Education Radiology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Hypertrophic olivary degeneration (HOD) is a rare type of neuronal degeneration seen after interruption of the dentato-rubro-olivary tract also known as the Guillain-Mollaret triangle (GMT). It is associated with hypertrophic changes of the inferior olive. Commonly reported in adults, this lesion presents with ataxia and oculopalatal myoclonus. Up to date, few cases have been published in the literature that refer to pediatric cases. This diagnosis is particularly important in the setting of brainstem tumor surgery as it should not be confused for tumor recurrence or metastasis, in turn avoiding unwarranted surgical intervention. We present the case of a 15-year-old male who underwent resection of a left superior cerebellar peduncle (SCP) pilocytic astrocytoma. On follow-up, magnetic resonance imaging (MRI) demonstrated evidence of mild residual tumor as well as progressive engorgement of the inferior olivary nucleus (ION). The patient was clinically asymptomatic and has since been observed expectantly without any issues. We were able to pinpoint the most probable location of injury in our patient’s GMT. HOD remains a somewhat obscure entity. Its presentation may be early and not accompanied by significant neurologic findings, in contrast to what has been previously reported. Particularly in neoplastic cases, it may represent a diagnostic challenge and could be easily confused for tumor recurrence. A multidisciplinary approach for this entity, as with other pathologies, is of particular importance. Its proper recognition will result in the best outcomes for the patient. |
| Databáze: | OpenAIRE |
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