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Hypertrophic olivary degeneration is a rare condition caused by damage within the triangle of Guillain and Mollaret. We discuss the anatomical, radiological, and clinical history of this rare condition. A 32-year-old lady presented with sub-acute headache, photophobia, and dizziness. She also described facial tingling and itching over her nose, and a thirty-minute episode of slurred speech. Magnetic resonance imaging revealed a 12.1 × 11 × 7.3 mm lesion arising from the floor of the fourth ventricle [Figure 1]. Postoperative imaging con
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