Question
A 27-year-old man is brought to the emergency department because of a knife wound to his back. His pulse is 110/min, respirations are 14/min, and blood pressure is 125/78 mm Hg. Examination shows a 5-cm deep stab wound at the level of T9. He withdraws the right foot to pain but is unable to sense vibration or whether his right toe is flexed or extended. Sensation in the left leg is normal. Motor strength is 5/5 in all extremities. Rectal tone is normal. Which of the following spinal column structures was most likely affected?
| A. |
Posterior spinal artery
|
| B. |
Dorsal root
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| C. |
Lateral corticospinal tract
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| D. |
Central spinal cord grey matter
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Show Answer
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Correct Answer � A
Explanation
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Answer A) Posterior spinal artery
A unilateral loss of proprioception and vibration with preservation of motor function and pain sensation indicates isolated damage to this patient’s dorsal column.
Posterior spinal artery
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Injury to the right posterior spinal artery leads to posterior spinal artery syndrome due to ischemia and subsequent infarction of the posterior column, which is directly supplied by this artery.
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Affected patients present with absent ipsilateral proprioception and vibration sensation below the level of the wound.
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In most cases, sensation to light touch is preserved. This patient’s normal motor function and sensation to pain rule out any further injury to the corticospinal tract and spinothalamic tract.
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