THE CERVICAL CORD IN MULTIPLE SCLEROSIS

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Abstract
The spinal cords were examined in 18 cases of multiple sclerosis, with special attention to the cervical enlargement. Lesions in the cervical cord were about twice as common as at lower levels. In this region there was a striking preponderance of fan-shaped lesions in the lateral columns. Mechanical stresses apparently play a part in determining the site of lesions and such stresses are commonly transmitted to the cord via the denticulate ligaments during flexion of the spine. Many of the lesions are probably attributable to vascular leakages due to tension in the denticulate ligaments. In patients with multiple sclerosis, neck flexion is dangerous, especially in cases where Lhermitte''s sign has occurred.