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Some little-known aspects of spinal cord softening

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Abstract

311 cases of spinal cord softening, were selected for review. The following points emerged from this study: 1) spinal cord softening is a rare occurrence; 2) while formerly syphilis was the most frequent cause, recently reports of cases secondary to aortic disease or to embolism with diffuse signs of arteriosclerosis and circulatory failure pointing to a different pathogenesis have become more frequent; 3) the site of softening rarely corresponds to the vascular spinal territories as defined by the anatomists, from which it may be argued that often several arterial territories may be involved simultaneously or, alternatively, that the arterial territories are not so rigidly defined as anatomical research has led us to suppose; 4) the few cases of multiple vascular lesions show that, as happens in the brain, the cord may be damaged contemporaneously or successively in several areas.

Sommario

Sulla base di 1230 segnalazioni bibliografiche pubblicate fra il 1832 e il 1986 sono stati selezionati 311 casi di rammollimento midollare primitivo tutti verificati con autopsia. Questa laboriosa indagine permette di ricavare questi dati: 1) il rammollimento midollare è evento raro; 2) mentre nel passato la sifilide era la causa più frequente in questa affezione, ultimamente sono stati segnalati sempre più numerosi casi secondari a malattia aortica o ad embolismo con una patogenesi che valorizza la presenza di segni diffusi di arteriosclerosi e una condizione di insufficienza circolatoria; 3) la sede del rammollimento raramente corrisponde ai territori delle arterie midollari. Si può perciò desumere che spesso più territori arteriosi possono essere interessati contemporaneamente o che essi non sono così rigidi come le ricerche anatomiche ci hanno fatto ritenere; 4) i pochi casi di lesione vascolare multipla dimostrano che, come avviene nel cervello, il midollo può essere offeso contemporaneamente o in successione in più aree.

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  1. Divisione Neurologica Ospedali Galleria, Via Volta, 16168, Genova

    Brusa A., Stoehr R. & Pizio N.

  2. Clinica delle Malattie Nervose e Mentali dell’Università, Genova

    Piccardo A.

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Brusa, A., Stoehr, R., Piccardo, A. et al. Some little-known aspects of spinal cord softening. Ital J Neuro Sci 8, 487–498 (1987). https://doi.org/10.1007/BF02334605

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