Abstract
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.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Afferent Pathways / pathology
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Afferent Pathways / physiopathology
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Brain Infarction / etiology
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Brain Infarction / pathology*
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Brain Infarction / physiopathology
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Brain Stem Infarctions / etiology
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Brain Stem Infarctions / pathology*
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Brain Stem Infarctions / physiopathology
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Central Venous Pressure / physiology
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Cerebral Veins / pathology
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Cerebral Veins / physiopathology
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Chronic Disease
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Disease Progression
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Female
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Humans
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Magnetic Resonance Imaging
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Male
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Medulla Oblongata / blood supply*
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Medulla Oblongata / pathology*
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Medulla Oblongata / physiopathology
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Middle Aged
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Multiple Sclerosis / complications
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Multiple Sclerosis / pathology*
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Multiple Sclerosis / physiopathology
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Paraparesis / etiology
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Paraparesis / pathology
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Paraparesis / physiopathology
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Pyramidal Tracts / pathology
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Pyramidal Tracts / physiopathology
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Retrospective Studies
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Somatosensory Disorders / etiology
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Somatosensory Disorders / pathology
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Somatosensory Disorders / physiopathology
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Venous Insufficiency / etiology
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Venous Insufficiency / pathology*
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Venous Insufficiency / physiopathology