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AJNR - American Journal of Neuroradiology

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Hypertrophic Olivary Degeneration: Metaanalysis of the Temporal Evolution of MR Findings

Mayank Goyal^a, Eric Versnick^a, Paul Tuite^a, Jean Saint Cyr^a, Walter Kucharczyk^a, Waltrer Montanera^a, Robert Willinsky^a and David Mikulis^,a

^a From the Departments of Medical Imaging (M.G., E.V., P.T., W.K., W.M., R.W., D.M.) and Surgery (J.S.C.), The Toronto Western Hospital of the University Health Network and University of Toronto, Toronto, Ontario, Canada.

View larger version (12K): [in a new window]   FIG 1. Time course of olivary hypertrophy. The data points indicate the presence or absence of hypertrophy based on MR findings as a function of time after onset of clinical symptoms. Note that there is a higher density of data points between 0.5 and 5 years for the hypertrophy present category, indicating a high likelihood of finding hypertrophy during this time frame. Also note the absence of hypertrophy both early and late in the course of the disease

View larger version (9K): [in a new window]   FIG 2. Time course of T2 signal intensity changes in HOD. The data points indicate the presence or absence of increased signal on T2-weighted MR images as a function of time after onset of clinical symptoms. Note that increased T2 signal is observed very early in the course of the disease and that the signal increase persists indefinitely

View larger version (14K): [in a new window]   FIG 3. General model of time course of hypertrophy and T2 signal intensity in HOD derived from figures 1 and 2. The negative slope in the dashed line is speculative, suggesting that the oliva becomes atrophic

View larger version (92K): [in a new window]   FIG 4. MR examination, 20 months after pontine hemorrhage. Axial T2-weighted fast spin-echo image (TR/TE = 6000/92, echo train length = 12) at the level of the ION shows hypertrophy with hyperintensity of bilateral ION.FIG 5. Follow-up axial T2-weighted fast spin-echo image (TR/TE = 5000/105, echo train length = 12) 49 months after hemorrhage into a pontine cavernoma shows hyperintensity in bilateral ION. No evidence of hypertrophy is present

View larger version (85K): [in a new window]   FIG 6. Drawing shows the triangle of Guillain and Mollaret