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A 71-year-old man presented with slowly progressive gait difficulty over several months due to left-sided ataxia, particularly affecting his leg. Fourteen months earlier, he had had a pontine hemorrhage (Figure 1A), causing left arm paralysis, from which he recovered. Magnetic resonance imaging (Figure 1B-D) showed findings consistent with hypertrophic olivary degeneration, ipsilateral to the prior bleed that had involved the central tegmental tract.
Marden FA. Hypertrophic Olivary Degeneration Due to Pontine Hemorrhage. JAMA Neurol. 2013;70(10):1330. doi:10.1001/2013.jamaneurol.359