Yamamoto T
Department of Neurology, Kitano Hospital.
No To Shinkei. 1989 Aug;41(8):777-80.
The aberrant pyramidal tracts in the pontine medial lemnisci were studied, using standard Sudan III stain, in six cases of chronic pyramidal tract degeneration. Three of the six cases had bilateral or unilateral cerebral destructive lesions, one cervical hematomyelia with rare retrograde pyramidal tract degeneration, one classical amyotrophic lateral sclerosis, and one atypical motor neuron disease with striatonigral degeneration. Except for the latter two cases the aberrant pyramidal tract degeneration was confirmed bilaterally or on the side ipsilateral to the pyramidal tract degeneration in the pontine base. This degeneration could also be found, on careful examination, with other stains, i.e., H & E, Luxol fast blue-periodic acid Schiff and modified Bielschowsky. Significant change was not observed in the medullary medial lemniscus in any case. The different results observed in the aberrant pyramidal tract between the destructive and degenerative disorders might be pathogenetically important. Reservation, however, may be required since the number of the cases of degenerative disorders in this study was limited. A possible factor for this difference is the survival length which might have erased degradation products altogether. Another factor is the sensitivity of Sudan III in comparison with the Marchi's method which might demonstrate more subtle evidence of degeneration but with its intrinsic capricious staining characteristics. The physiological role of the aberrant pyramidal tract, which has been neglected in the recent textbooks of neuroanatomy, may become of clinical interest with high-quality MRI in cases such as isolated cranial motor nerve palsy without concomitant paralysis of the extremities.
采用标准苏丹Ⅲ染色法，对6例慢性锥体束变性患者脑桥内侧丘系中的异常锥体束进行了研究。6例患者中，3例有双侧或单侧脑破坏性病变，1例为颈髓出血性脊髓炎伴罕见的锥体束逆行性变性，1例为典型肌萎缩侧索硬化，1例为非典型运动神经元病伴纹状体黑质变性。除后两例外，异常锥体束变性在双侧或脑桥基底部锥体束变性同侧得到证实。仔细检查还发现，用其他染色方法，即苏木精-伊红染色、Luxol固蓝-过碘酸希夫染色和改良 Bielschowsky 染色，也能发现这种变性。所有病例的延髓内侧丘系均未观察到明显变化。在破坏性疾病和变性疾病中异常锥体束观察到的不同结果可能具有重要的发病机制意义。然而，由于本研究中变性疾病的病例数量有限，可能需要保留意见。造成这种差异的一个可能因素是存活时间，它可能已经完全消除了降解产物。另一个因素是苏丹Ⅲ与 Marchi 法相比的敏感性，Marchi 法可能能显示出更细微的变性证据，但具有其固有的多变染色特性。在最近的神经解剖学教科书中被忽视的异常锥体束的生理作用，在诸如孤立性颅神经运动麻痹而无肢体瘫痪的病例中，随着高质量 MRI 的应用，可能会引起临床关注。
