Vuia O
Acta Neurol Scand. 1977 Apr;55(4):289-98. doi: 10.1111/j.1600-0404.1977.tb05648.x.
The present paper is a study of three cases presenting the pathological aspect of chronic, non-evolutive multiple sclerosis, corresponding to a clinical picture of benign multiple sclerosis. The first case was discovered at autopsy, the second patient had two subclinical attacks of multiple sclerosis, with a twenty-year evolution (forme fruste), and in the third case the course of the chronic multiple sclerosis ran parallel to that of a cerebral and visceral arteriopathy. Anatomic study of the demyelinating lesions revealed their non-evolutive aspect and the presence within the plaques of lesions of the walls of small vessels with the perivascular adventitial fibrosis. The vascular changes appear to play a primordial role in the lack of evolution of the demyelinating areas, manifested clinically by a stationary, benign picture.
本文是对三例呈现慢性、非进展性多发性硬化症病理特征病例的研究,这与良性多发性硬化症的临床表现相符。第一例是在尸检时发现的,第二例患者有两次多发性硬化症亚临床发作,病程长达二十年(顿挫型),第三例慢性多发性硬化症的病程与脑和内脏动脉病变的病程平行。对脱髓鞘病变的解剖学研究显示其非进展性特征以及斑块内存在伴有血管周围外膜纤维化的小血管壁病变。血管变化似乎在脱髓鞘区域缺乏进展中起主要作用,临床上表现为静止的良性症状。