Which syndrome injures the anterior aspect of the spinal cord causing paralysis and loss of pain and temperature with preserved position sense?

• A. Anterior Cord Syndrome
• B. Central Cord Syndrome
• C. Brown-Sequard Syndrome
• D. Posterior Column Syndrome

Answer: (A)

Damage to the anterior two-thirds of the spinal cord disrupts the motor pathways and the pain/temperature tracts while leaving the dorsal columns intact. This means below the injury there is paralysis (corticospinal tract involvement) and loss of pain and temperature sensation (spinothalamic tracts), but position sense, vibration, and fine touch are preserved because the posterior columns are spared. This pattern is characteristic of anterior cord syndrome and is often due to anterior spinal artery compromise or injury to the anterior cord.

In other syndromes, the presentation differs: central cord syndrome tends to cause more weakness in the arms, with relative sparing of the legs; Brown-Sequard produces ipsilateral motor loss and loss of position/vibration with contralateral loss of pain and temperature; posterior column syndrome primarily affects proprioception and vibration with intact motor and pain/temperature pathways.