Basic Human Neuroanatomy
A Clinically Oriented Atlas 
Case 149 Answers

1.  Is the patient’s left-sided weakness suggestive of an upper motor neuron or lower motor neuron process?

Upper motor neuron

2.  Indicate the specific structures involved by the pathologic process to produce this patient’s left-sided weakness, increased muscle tone, hyperreflexia, and extensor plantar reflex. 

Left lateral corticospinal tract, involving the C6-7 spinal cord segments

3.  What sensory pathway is involved to produce this patient’s pain and temperature deficit?

Left spinothalamic tract, at about the C6-8 spinal cord level

4.  What sensory pathways are involved to produce this patient’s mild joint position sense (conscious proprioception) deficits?

Left fasciculi cuneatus and gracilis, at or above the C7 spinal cord level

5.  Indicate the anatomical location of the pathologic process in this case. 

Left cervical spinal cord, maximal at ~ C7

6.  In general, what type of pathologic process do you think is involved in this case?

Post-traumatic myelomalacia of the left cervical spinal cord, maximal at ~ C7

7.  This patient’s clinical signs and symptoms constitute a classic neurologic syndrome.  What is the name of that syndrome? 

Brown-Sequard Syndrome (Hemisection of the spinal cord)

8.  What diagnostic procedure(s) would you undertake at this point?


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