A 45-year-old woman presents with sudden-onset weakness of the right lower extremity and loss of pain and temperature sensation on the left side of her body below the neck. Vital signs: BP 158/92 mmHg, HR 88, RR 16, Temp 37°C, SpO2 98%. MRI demonstrates an acute infarct in the left medulla. Neurologic exam reveals intact right facial sensation. Which of the following tracts is most likely damaged?
- A)Medial longitudinal fasciculus and corticobulbar tract
- B)Lateral corticospinal tract and spinal trigeminal nucleus
- C)Medial lemniscus and hypoglossal nerve fibers
- D)Spinocerebellar tract and vestibulospinal pathway
- E)Lateral spinothalamic tract and pyramidal fibersGABARITO
Explicação
This clinical presentation is classic for Wallenberg syndrome (lateral medullary syndrome). The lateral spinothalamic tract carries crossed pain and temperature sensation; damage causes contralateral loss. Pyramidal fiber damage causes ipsilateral weakness. Th... Ver explicação completa e trilha adaptativa →