Lin Lin, Ye Xiaofeng, Zheng Jianming
Department of Neurology, Mindong Hospital Affiliated to Fujian Medical University, Heshan Road No.89, Fu'an, 355000, Fujian Province, China.
School of Clinical Medicine, Fujian Medical University, Fuzhou, 350122, China.
Sci Rep. 2025 Aug 25;15(1):31262. doi: 10.1038/s41598-025-14912-1.
Patients who have experienced bleeding in the posterior circulation of the brain often develop Hypertrophic Olivary Degeneration (HOD). This condition can lead to new neurological problems several months after the initial hemorrhage, potentially worsening the overall outcome for these patients. However, its pathogenesis and prognosis remain inconclusive. The research included 214 patients diagnosed with brainstem or cerebellar hemorrhage, of which 36 developed secondary HOD. The study aimed to analyze the clinical data of these patients, investigate the risk factors associated with HOD development, and evaluate the prognosis for those affected. (1) No significant differences in common cerebrovascular risk factors, such as hypertension and diabetes, were observed between the HOD and non-HOD groups among patients with lesions involving the Guillain-Mollaret triangle (GMT) (P > 0.05). (2) The site of hemorrhage was significantly correlated with the location of HOD (P < 0.05). (3) A significant association was found between the primary lesion's site and the interval before HOD onset (P < 0.05). (4) Patients in the HOD group showed poorer functional outcomes, reflected by higher mRS scores (Z = -2.859, P = 0.004) and lower ADL scores (Z = -2.859, P = 0.004). Among patients with brainstem or cerebellar hemorrhage, all individuals with HOD had lesions involving the GMT. A significant correlation was identified between the site of hemorrhage and the location of HOD. Cerebellar hemorrhage cases were associated with shorter intervals before HOD onset, and HOD was linked to significantly worse functional outcomes.
经历过脑后部循环出血的患者常发生肥厚性橄榄核变性（HOD）。这种情况可在初次出血数月后导致新的神经问题，可能使这些患者的总体预后恶化。然而，其发病机制和预后仍不明确。该研究纳入了214例被诊断为脑干或小脑出血的患者，其中36例发生继发性HOD。该研究旨在分析这些患者的临床数据，调查与HOD发生相关的危险因素，并评估受影响患者的预后。（1）在累及Guillain-Mollaret三角（GMT）的患者中，HOD组和非HOD组在高血压和糖尿病等常见脑血管危险因素方面无显著差异（P>0.05）。（2）出血部位与HOD的位置显著相关（P<0.05）。（3）发现原发性病变部位与HOD发病前的间隔时间之间存在显著关联（P<0.05）。（4）HOD组患者的功能预后较差，表现为较高的改良Rankin量表（mRS）评分（Z=-2.859，P=0.004）和较低的日常生活活动能力（ADL）评分（Z=-2.859，P=0.004）。在脑干或小脑出血的患者中，所有发生HOD的个体均有累及GMT的病变。出血部位与HOD的位置之间存在显著相关性。小脑出血病例与HOD发病前的间隔时间较短有关，且HOD与明显更差的功能预后相关。
