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Multiple sclerosis with hydromyelia demonstrated at autopsy
B K Kleinschmidt-DeMasters1, J Newell
1Department of Pathology, University of Colorado Health Sciences Center, Denver 80262, USA.
Abstract:
Multiple sclerosis (MS) associated with intramedullary cysts has been recently documented radiographically in approximately a dozen cases, but histological confirmation in these cases has been lacking. These cysts have been noted to occur centrally in the spinal cord and have been previously diagnosed as syringomyelia. We report a patient with extensive hydromyelia, but no dissecting syringomyelic cavity, of the thoraco-lumbar spinal cord, which was co-existent with centrally located, non-necrotic, chronic demyelinative plaques. A few well demarcated non-necrotic plaques were seen in the cerebrum and cerebellum with sparing of optic chiasm, confirming the diagnosis of chronic, non-Devic type MS. Although a cause and effect between the hydromyelia and MS cannot be proven in this or any of the previously reported radiographic cases our report provides pathological confirmation of the association between these two entities and further delineates the type of cyst.
Insights
This study provides the first pathological confirmation of a link between multiple sclerosis (MS) and intramedullary cysts. The findings detail a case of hydromyelia co-existing with chronic demyelinative plaques in MS.
Area of Science:
- Neurology
- Pathology
- Radiology
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system.
- Intramedullary cysts, previously diagnosed as syringomyelia, have been radiographically associated with MS in limited cases.
- Histological confirmation of this association has been lacking.
Observation:
- A patient presented with extensive hydromyelia of the thoraco-lumbar spinal cord.
- The hydromyelia was co-existent with centrally located, non-necrotic, chronic demyelinative plaques.
- Cerebral and cerebellar plaques were observed, with sparing of the optic chiasm, consistent with chronic, non-Devic type MS.
Findings:
- This report provides the first pathological confirmation of the association between intramedullary hydromyelia and multiple sclerosis.
- The observed cysts were characterized as hydromyelia, not a dissecting syringomyelic cavity.
- The study delineates the specific type of cyst associated with MS.
Implications:
- This pathological evidence supports a connection between MS and intramedullary cysts.
- Further research is warranted to understand the causal relationship, if any, between these two conditions.
- The findings contribute to a better understanding of MS-associated spinal cord abnormalities.