… Images in BMJ Case Reports: first published as 10.1136/bcr-2015-210334 on 2 July 2015. Downloaded from Hypertrophic olivary degeneration secondary to traumatic brain injury: a unique form of trans-synaptic degeneration Raman Mehrzad,1 Michael G Ho2 1Department of Medicine, DESCRIPTION haemorrhagic left superior cerebellar peduncle, all Steward Carney Hospital, Tufts A 33-year-old man with a history of traumatic brain consistent with his prior TBI. Moreover, the right University School of Medicine, Boston, Massachusetts, USA injury (TBI) from a few years prior, secondary to a inferior olivary nucleus was enlarged, which is 2Department of Neurology, high-speed motor vehicle accident, presented with exemplified in unilateral right hypertrophic olivary Steward Carney Hospital, Tufts worsening right-sided motor function. Brain MRI degeneration (HOD), likely secondary to the haem- University School of Medicine, showed diffuse axonal injury, punctuate microbleed- orrhagic lesion within the left superior cerebellar Boston, Massachusetts, USA ings, asymmetric Wallerian degeneration along the peduncle, causing secondary degeneration of the fi – Correspondence to left corticospinal tract in the brainstem and contralateral corticospinal tracts ( gures 1 6). Dr Raman Mehrzad,
[email protected] Accepted 11 June 2015 http://casereports.bmj.com/ fl Figure 3 Brain axial gradient echo MRI showing Figure 1 Brain axial uid-attenuated inversion recovery haemosiderin products in the left superior cerebellar MRI showing hypertrophy of the right inferior olivary peduncle. nucleus. on 25 September 2021 by guest. Protected copyright. To cite: Mehrzad R, Ho MG. BMJ Case Rep Published online: [please include Day Month Year] Figure 2 Brain axial T2 MRI showing increased T2 Figure 4 Brain axial gradient echo MRI showing doi:10.1136/bcr-2015- signal change and hypertrophy of the right inferior evidence of haemosiderin products in the left>right 210334 olivary nucleus.