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.