Krings T, Foltys H, Meister I G, Reul J
Department of Neuroradiology, University Hospital of the University of Technology, Aachen, Germany.
J Neurol Neurosurg Psychiatry. 2003 Jun;74(6):797-9. doi: 10.1136/jnnp.74.6.797.
The clinical and magnetic resonance (MR) features of hypertrophic olivary degeneration are described, along with a rare but treatable cause of this entity-pontine cavernous haemangioma. Hypertrophic olivary degeneration occurs after focal lesions to the dentato-rubro-olivary pathway, typically following a pontine haemorrhage involving the ipsilateral central tegmental tract, the contralateral superior cerebellar peduncle, or the dentate nucleus. Clinically, there is palatal myoclonus and an uncontrollable tremor, presumably caused by loss of inhibitory control. On MR imaging, hypertrophic olivary degeneration is characterised by a non-enhancing T1 isointense, T2 hyperintense enlargement confined to the olivary nucleus. Typically, haemorrhages following a hypertensive crisis are responsible for hypertrophic olivary degeneration. However, in the three reported cases, imaging findings within the former bleeding cavity suggested a cavernous haemangioma as the source of the haemorrhage.
本文描述了肥厚性橄榄体变性的临床和磁共振（MR）特征，以及该病症一种罕见但可治疗的病因——脑桥海绵状血管瘤。肥厚性橄榄体变性发生于齿状核-红核-橄榄体通路的局灶性病变之后，通常继发于累及同侧中央被盖束、对侧上小脑脚或齿状核的脑桥出血。临床上，会出现腭肌阵挛和无法控制的震颤，推测是由于抑制性控制丧失所致。在MR成像上，肥厚性橄榄体变性的特征是局限于橄榄核的T1等信号、T2高信号且无强化的增大。通常，高血压危象后的出血是肥厚性橄榄体变性的病因。然而，在报告的3例病例中，先前出血腔内的影像学表现提示海绵状血管瘤是出血的来源。
