Topographic Distribution of Plaques in the Spinal Cord in Multiple Sclerosis

Wedge-shaped medullary lesions in multiple sclerosis

“…However, previous reports have not described the morphology of medullary lesions and we have not found any previous descriptions of wedge-shaped lesions. Such lesions are however wellrecognised in the spinal cord where a circulatory disturbance has been proposed as the possible cause [7,8]. The location of the lesions in the paramedian ventral medulla in the present cases was also unusual as, with rare exceptions, demyelinating lesions in the brainstem are situated more in the periaqueductal region and dorsal brainstem in contiguity with the cisternal and ventricular cerebrospinal fluid spaces [5].…”

“…Interestingly, the anatomy of the medullary veins is similar to that of the veins draining the spinal cord [16]. Similar peripheral wedge-shaped MS lesions were also described in the spinal cord in early neuropathological studies and lead to the suggestion that there may be an underlying circulatory disturbance [7,8]. The wedge shape of the medullary lesions could also occur if the demyelinating process is confined to the paramedian white matter (the pyramids and medial lemniscus) and does not extend laterally into the inferior olivary nuclei (Fig.…”

Treatment of the Neurogenic Bladder with Direct Current on the Spinal Cord (Myelotron)

“…The topographic distribution of plaques in the spinal cord in multiple sclerosis is found in the center and in the posterior two thirds of the lateral columns as the site of predilection, mainly bilaterally (4). From the cystometric point of view, there are no differences between multiple sclerosis patients suffering from supranuclear lesions of the vesical pathways (1 ,9 ).…”

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“…This circumstance applies first to the extension and severity of the finger-shaped demyelination invading the semioval center via larger venules (Dow, Berglund 1942, Fog 1950). Lhermitte (1950) and Lumsden (1975) The striking proclivity to thromboses affecting veins downstream of recent plaques (Rossolimo 1904, Putnam 1937, Dow, Berglund 1942, Prineas 1975) possibly relates to vein wall damages due to reflux.…”