Wedge-shaped medullary lesions in multiple sclerosis.
Multiple sclerosis (MS) is a heterogeneous disease with variable clinical features and magnetic resonance imaging (MRI) findings. We report four MS cases with unusual wedge-shaped lesions in the paramedian ventral medulla oblongata demonstrated on MRI. The clinical features and MRI characteristics of the medullary lesions suggest an impairment of venous drainage. We propose that the formation of these wedge-shaped lesions may be related to the pattern of venous drainage in the ventral medulla and raised venous pressure due to chronic cerebrospinal venous insufficiency which has recently been described in MS.
Qiu
Wei
W
Centre for Neuromuscular and Neurological disorders, University of Western Australia, Australia.
Raven
Sonja
S
Wu
Jing-Shan
JS
Carroll
William M
WM
Mastaglia
Frank L
FL
Kermode
Allan G
AG
D000328:Adult; D000344:Afferent Pathways / Q000473:pathology / Q000503:physiopathology; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D020526:Brain Stem Infarctions / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D002496:Central Venous Pressure / Q000502:physiology; D002550:Cerebral Veins / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000098:blood supply* / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D020335:Paraparesis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D020886:Somatosensory Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014689:Venous Insufficiency / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology