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成人后颅窝肿瘤切除术后的肥大性橄榄体变性:病例说明

Hypertrophic olivary degeneration after posterior cranial fossa tumor resection in adults: illustrative case.

作者信息

Venegas Joshua M, Miller Aaron, Small Coulter, Strickland Ben A

机构信息

Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina.

出版信息

J Neurosurg Case Lessons. 2025 Apr 28;9(17). doi: 10.3171/CASE25130.

Abstract

BACKGROUND

Posterior cranial fossa tumor resection can be complicated by a rare but potentially debilitating condition known as hypertrophic olivary degeneration (HOD). This condition is diagnosed using a high degree of clinical suspicion as well as T2/FLAIR MRI findings of nonenhancing, hyperintense enlargement of the inferior olivary nucleus.

OBSERVATIONS

The authors present a unique case of HOD in a 49-year-old female 4 months after resection of a low-grade pilocytic astrocytoma from the cerebellar vermis. The patient displayed classic signs associated with HOD, including palatal tremor, ocular nystagmus, and ocular myoclonus. Management will likely be challenging, and the patient was referred to movement disorder specialists to discuss potential treatment options.

LESSONS

Few case reports of HOD after neurosurgical intervention in adults are available in the literature. In this work, the authors conducted a literature review of available data for 23 cases of HOD in adult patients after midline posterior cranial fossa tumor resection. The prognosis of symptomatic HOD is generally poor, as no standardized treatment regimen for these patients currently exists. https://thejns.org/doi/10.3171/CASE25130.

摘要

背景

后颅窝肿瘤切除术后可能会并发一种罕见但可能使人衰弱的疾病,称为肥大性橄榄核变性(HOD)。这种疾病通过高度的临床怀疑以及T2/液体衰减反转恢复序列(FLAIR)磁共振成像(MRI)显示下橄榄核无强化、高强度增大的表现来诊断。

观察结果

作者报告了一例独特的HOD病例,患者为49岁女性,在从小脑蚓部切除低度毛细胞型星形细胞瘤4个月后发病。该患者表现出与HOD相关的典型体征,包括腭震颤、眼球震颤和眼肌阵挛。治疗可能具有挑战性,该患者被转诊至运动障碍专科医生处讨论潜在的治疗方案。

经验教训

文献中关于成人神经外科手术后HOD的病例报告很少。在这项研究中,作者对23例中线后颅窝肿瘤切除术后成年患者的HOD可用数据进行了文献综述。有症状的HOD预后通常较差,因为目前尚无针对这些患者的标准化治疗方案。https://thejns.org/doi/10.3171/CASE25130

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2acb/12036356/4fac06892e98/CASE25130_figure_1.jpg

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本文引用的文献

1
Hypertrophic Olivary Degeneration Postoperatively Following Pilocytic Astrocytoma Resection.
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Hypertrophic olivary degeneration: A comprehensive review focusing on etiology.
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