A 29 year old woman has progressive numbness over both shoulders and upper arms. She reports burning herself while cooking without noticing until later. Examination shows bilateral loss of pain and temperature sensation over the upper extremities in a cape like distribution with preserved light touch and vibration. Hand grip strength is mildly reduced. Which structure is most likely damaged first?
- A)Lateral corticospinal tracts
- B)Spinocerebellar tracts
- C)Anterior white commissureGABARITO
- D)Dorsal columns
- E)Substantia nigra
Explicação
Anterior white commissure is correct. A central cavitation of the spinal cord interrupts decussating spinothalamic fibers crossing in the anterior white commissure, causing bilateral cape like loss of pain and temperature. Expansion can later involve anterior ... Ver explicação completa e trilha adaptativa →