Wedge-shaped medullary lesions in multiple sclerosis.
Qiu W, Raven S, Wu JS, Carroll WM, Mastaglia FL, Kermode AG.
Centre for Neuromuscular and Neurological disorders, University of Western Australia, Australia;
Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia;
Department of Neurology, the Third Affiliated Hospital of Sun yat-sen University, Guangzhou, China.
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. Copyright © 2010 Elsevier B.V. All rights reserved.