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J Stroke Cerebrovasc Dis. 2014 Mar;23(3):554-6. doi: 10.1016/j.jstrokecerebrovasdis.2013.03.025. Epub 2013 Apr 17.

Panmedullary edema with inferior olivary hypertrophy in bilateral medial medullary infarction.

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  • 1Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • 2Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan. Electronic address:
  • 3Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan.


Bilateral medial medullary infarction (MMI) is a rare type of stroke with poor outcomes. Inferior olivary nucleus hypertrophy results from a pathologic lesion in the Guillain-Mollaret triangle. The relationship between inferior olivary nucleus hypertrophy and the medullary lesion is obscure. To the best of our knowledge, only 1 autopsy case with unilateral medial medullary infarction that was associated with ipsilateral inferior olivary nucleus hypertrophy has been reported. We describe a rare case with acute infarction in the bilateral medial medulla oblongata accompanied by subacute bilateral inferior olivary nucleus hypertrophy and panmedullary edema. The hypertrophy appeared to have been caused by local ischemic damage to the termination of the central tegmental tract at the bilateral inferior olivary nucleus.

Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.


Guillain–Mollaret triangle; intracranial dissection; medullary infarction; olivary nucleus hypertrophy

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