Yamamoto T, Yamasaki M, Imai T
Department of Neurology, Kitano Hospital and Neurological Centre, Tazuke-Kofukai Medical Research Institute, Osaka, Japan.
J Neurol Neurosurg Psychiatry. 1989 Mar;52(3):382-6. doi: 10.1136/jnnp.52.3.382.
Retrograde pyramidal tract degeneration has been described only very rarely in the human central nervous system. In most of these cases the thoracic or cervical corticospinal tracts were shown to have degenerated following long-standing, lower spinal cord lesions. In a 67 year old man, who lived 2 years following the rupture of a mid-cervical cavernous angioma, we observed such degeneration which reached as high as the pons. This axonal dissolution was much less manifest above the ponto-medullary junction. Large pyramidal cells of Betz were not identified in the precentral gyrus, suggesting that the parental soma of the damaged axons had undergone atrophic changes. Furthermore, the involvement of the so-called aberrant pyramidal tract in the pontine medial lemniscus indicated that retrograde degeneration had occurred there as well.
逆行性锥体束变性在人类中枢神经系统中极为罕见。在大多数此类病例中，胸段或颈段皮质脊髓束在脊髓长期低位病变后出现变性。在一名67岁男性中，他在颈中部海绵状血管瘤破裂后存活了2年，我们观察到这种变性高达脑桥。这种轴突溶解在脑桥延髓交界处上方不太明显。中央前回未发现大型贝茨锥体细胞，提示受损轴突的亲代胞体发生了萎缩性改变。此外，脑桥内侧丘系中所谓的异常锥体束受累表明此处也发生了逆行性变性。
