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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
09:41

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Published on: July 19, 2019

Perivascular iron deposition and other vascular damage in multiple sclerosis

C W Adams1

  • 1Division of Histopathology, United Medical School of Guy's Hospital, University of London, UK.

Journal of Neurology, Neurosurgery, and Psychiatry
|February 1, 1988
PubMed

Insights

Multiple sclerosis (MS) patients exhibit significant cerebral vein wall damage, including inflammation and hemorrhage. This suggests MS involves a form of vasculitis affecting brain veins.

Area of Science:

  • Neurology
  • Pathology
  • Immunology

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
  • The role of cerebral vasculature in MS pathogenesis remains incompletely understood.

Purpose of the Study:

  • To investigate evidence of damage to cerebral vein walls in multiple sclerosis (MS) patients.
  • To compare the findings in MS cases with a control group.

Main Methods:

  • Histopathological examination of cerebral venous tissue from 70 MS cases and 70 controls.
  • Assessment for specific markers of vascular damage such as fibrinoid deposition, hemorrhage, haemosiderin, thrombosis, and vein wall thickening.

Main Results:

  • 41% of MS cases showed evidence of cerebral vein damage, including fibrinoid deposition (7%), recent hemorrhage (17%), old hemorrhage/haemosiderin (30%), thrombosis (6%), and thickened veins (19%).
  • Control cases showed minimal, diffuse haemosiderin deposition, primarily linked to cardiovascular/cerebrovascular disease, unlike the localized findings in MS.
  • Haemosiderin deposition was common in pigmented nuclei in all cases, irrespective of disease status.

Conclusions:

  • Cerebral vein walls in MS are subject to chronic inflammatory damage.
  • This damage promotes hemorrhage and increased vascular permeability, indicating a potential vasculitic component in MS.
  • The findings suggest that cerebral vein pathology is a significant feature of multiple sclerosis.

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