The distribution of plaques in the cerebrum in multiple sclerosis

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Abstract
The position and relative frequency of the pathological lesions called plaques in the cerebral hemispheres of 22 unselected necropsied cases of multiple sclerosis are presented. The distribution of 1,594 plaques was in order of decreasing frequency as follows: lateral ventricular system, frontal lobe, parietal lobe, temporal lobe, internal nuclei, corpus callosum, insula, internal capsule and occipital lobe. The lateral ventricular system accounted for 637 or 40% of the plaques. The greatest number 1,184 (74%) were found in the white matter. This was followed in frequency by the junction of cortex and white matter, cortex and central gray matter. It was demonstrated that all parts of the cerebrum are vulnerable to plaque formation with no differences between left and right hemispheres. Theories involving a toxin circulating in the cerebrospinal fluid do not completely explain the position of the periventricular plaques. It may be of etiological significance that plaques were more commonly found in relatively avascular areas.