Question

A 37-year-old man is brought into the emergency department after being stabbed in the flank during a bar fight. On examination, the patient has 2/5 strength and decreased vibration sense in his left lower extremity as well as decreased pinprick sensation in his right lower extremity. Which of the following is the most likely pattern of this patient's injury?

a) The corticobulbar tract was transected on the left
b) The corticospinal tract was transected on the right
c) The dorsal column was transected on the right
d) The spinothalamic tract was transected on the left

Answer 1

Following a hemisection in the thoracic region of the spinal cord, sensory deficits in terms of touch and pain can be observed. Fine touch and proprioceptive sensations would be lost on the side of the trauma, while perception of pain stimuli would be lost on the opposite side of the trauma.

Step-by-step explanation:

Following a hemisection in the thoracic region of the spinal cord, the sensory deficits in terms of touch versus pain can be explained as follows:

Touch:

On the side of the trauma, there would be a loss of fine touch and proprioceptive sensations. This is because the dorsal column pathway on the same side as the trauma would be damaged.

Pain:

On the opposite side of the trauma, there would be a loss of perception of pain stimuli. This is because the spinothalamic pathway, which decussates immediately upon entering the spinal cord and ascends contralateral to the source, would bypass the hemisection.