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The history of this patient is characteristic of softening of the spinal cord (myelomalacia) in that the onset of the paraplegia was sudden and there was no recovery of function in the paralyzed members. There is an axiom in neurological diagnosis that paraplegia of sudden onset is usually due to occlusion of spinal vessels. The notable exceptions to this axiom are traumatic injuries to the spine and acute transverse myelitis associated with multiple sclerosis or other demyelinating diseases.
The clinician who studied this case presumably did not consider arteriosclerosis as a likely cause of the patient's symptoms. Arteriosclerosis of cerebral vessels is the commonest cause of focal lesions in the brain, but focal lesions in the spinal cord are rarely the result of arteriosclerosis of the spinal vessels. Occlusion of the vessels of the spinal cord is usually associated with inflammatory disease of the vessels (syphilis, tuberculosis, epidural abscess, and
Merritt HH. COMMENT. JAMA. 1954;155(4):362. doi:10.1001/jama.1954.73690220005008a
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