Spinal Necrosis and Softening of Obscure Origin

There are numerous reports in the literature, under varying designations, concerning diseases of the spinal cord of undetermined origin, with softening or necrosis the prominent postmortem feature. The subject has been one of general confusion. No classification has been possible in the face of ignorance of etiologic factors; pathogenesis has been equally uncertain, and the interpretation of pathologic material has produced no uniformity of opinion regarding the nature of the morbid changes. Some investigators have assumed the process to be inflammatory and have applied the term "necrotic myelitis." Others have preferred "myelomalacia," to indicate the degenerative features. Several other descriptive titles have been used. A review of the numerous reports may be helpful in drawing a general picture and in correlating the various opinions which have been advanced. In 1926, Foix and Alajouanine1published a report of 2 cases which they believed represented a new disease entity, subacute necrotic