Wedge-shaped medullary lesions in multiple sclerosis.
Qiu W, Raven S, Wu JS, Carroll WM, Mastaglia FL, Kermode AG.
Centre for Neuromuscular and Neurological disorders, University of Western Australia, Australia.
Multiple sclerosis (MS) is a heterogeneous disease with variable clinical features and magnetic resonance imaging (MRI) findings. We report four MS cases with unusual wedge-shaped lesions in the paramedian ventral medulla oblongata demonstrated on MRI. The clinical features and MRI characteristics of the medullary lesions suggest an impairment of venous drainage. We propose that the formation of these wedge-shaped lesions may be related to the pattern of venous drainage in the ventral medulla and raised venous pressure due to chronic cerebrospinal venous insufficiency which has recently been described in MS.
Anterior medullary vein in relation to the medulla and vertebral arteries
A and B, Anteroposterior (A) and lateral (B) anatomic diagrams demonstrate the anatomy of the PMVs in relation to the vertebrobasilar system. 1 indicates interpeduncular vein; 2, basal vein of Rosenthal; 3, posterior cerebral artery; 4, superior cerebellar artery; 5, anterior PMV; 6, petrosal vein; 7, anterior inferior cerebellar artery; 8, vertebral artery; 9, anterior medullary vein; 10, posterior inferior cerebellar artery; 11, basilar artery; 12, transverse pontine vein; 13, lateral mesencephalic vein; 14, internal cerebral vein; 15, inferior sagittal sinus; 16, vein of Galen; 17, sraight sinus; 18, superior sagittal sinus.
Veins of the Posterior Fossa (lots of real vein images)-have no idea of this is useful but discusses venous congestion, etc.
http://neuroangio.org/venous-brain-anat ... ior-fossa/