D.D.between MS and Ischemic disease.

Multiple sclerosis:

• 

Coronal PD image of a brain specimen with MS involvement

The lesions in the deep white matter (yellow arrow) are non specific and can be seen in many diseases.


Typical for MS in this case is:

• Involvement of the temporal lobe (red arrow)
• Juxtacortical lesions (green arrow) - touching the cortex
• Involvement of the corpus callosum (blue arrow)
• Periventricular lesions - touching the ventricles

 

 

 

To search for MS, you must find the following WML in specific sites such as:

 

-Corpus callosum:

 

-U-fibers:

 

 The short association fibers (also often referred to as "U-fibers") lie immediately beneath the gray substance of the cortex of the hemispheres, and connect together adjacent gyri.

 

 

-Infra tentorial:Cerebellum.

 

- Temporal lobe: early findings.

-Peri ventricular:

-Spinal cord:

-Ga enhancement: yes.

-Dawson's fingers:

-Distribution: Symmetric / diffuse.

Vascular lesions:

-Cortical lesions: Infarction.

-Basal ganglia: Typical.

-Distribution: Assymetric.

So in case of MS; there is many sites of common affection which are:

* Corpus callosum.

*Then look above it for U-fibers.

*Then down to temporal lobe.

*then on both sides for peri ventricular areas.

*Then look back and down to cerebellum.

*Then down to spinal cord.

All these lesions are symmetrical.