In central cord syndrome, which tract is commonly affected leading to sensory symptoms?

• A. Spinothalamic tract (STT)
• B. Dorsal columns (DCML)
• C. Corticospinal tract
• D. Rubrospinal tract

Answer: (A)

Central cord syndrome damages the center of the cervical spinal cord, where the spinothalamic tract fibers that carry pain and temperature cross and ascend. Since these crossing fibers are interrupted at the level of injury, you see loss of pain and temperature sensations in the affected limbs, often more pronounced in the upper extremities. The dorsal columns, which carry fine touch and proprioception, are located posteriorly and tend to be spared early on, while motor signs come from involvement of the corticospinal (and related) pathways. So the sensory symptoms in this pattern point to disruption of the spinothalamic tract.