Neuroanatomy USMLE Step 1 Practice Question
A 60-year-old man with a 10-year history of hypertension presents to the emergency department with acute onset of weakness and sensory changes. On examination, he has intact motor strength throughout, but demonstrates loss of proprioception and vibration sense below the right nipple line. Notably, he has preserved pain and temperature sensation on the right but loss of pain and temperature sensation on the left side below the nipple line. MRI of the thoracic spine reveals a focal intramedullary lesion at the T4 level. Which spinal cord syndrome best explains this clinical presentation?
Answer choices
- ALeft anterior spinal artery syndrome
- BCentral cord syndrome
- CRight-sided Brown-Séquard syndromeCorrect answer
- DLeft-sided hemisection of the spinal cord
- EIsolated dorsal column lesion on the right
- FComplete spinal cord transection at T4
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