Spinothalamic Damage - Causes, Symptoms, Diagnosis, and Treatment

Creator: Dr. Shanthwani Francis
Published: 2023-04-04T15:59:50

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The spinothalamic tract is a pathway that carries temperature, touch, and pressure from the skin to the somatosensory area of the thalamus in the brain.

Written by

Dr. Shanthwani Francis

Medically reviewed by

Dr. Prakashkumar P Bhatt

April 4, 2023

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Contents

What Is Spinothalamic Tract?
What Are the Parts of the Spinothalamic Tract?
What Is the Clinical Significance of Spinothalamic Tract?
What Are the Causes of Spinothalamic Injury?
What Are the Symptoms of Spinothalamic Injury?
How to Diagnose Spinothalamic Damage?
How to Treat Spinothalamic Damage?

Introduction:

The spinothalamic tract is a sensory tract that carries sensations from the skin to the somatosensory cortex (an area that collects and processes sensory information from the entire body) of the brain. It is often responsible for rapid actions like instant withdrawal of the hand to a painful stimulus like touching the stove burner. The spinothalamic tract is a sensory pathway that does not have much role in performing motor functions.

What Is Spinothalamic Tract?

The spinothalamic tract is one of the most important pathways of the nervous system. It is an ascending pathway of the spinal cord. The spinothalamic tract transmits sensory information like touch, pain, and temperature from the free nerve endings present in the skin and related tissues. The spinothalamic tract is also known as the ventrolateral or anterolateral system.

What Are the Parts of the Spinothalamic Tract?

The spinothalamic tract is made up of four parts. They are as follows:

Anterior Spinothalamic Tract: The anterior spinothalamic tract is responsible for carrying signals of crude touch (sensory ability to feel the touch but unable to localize the area of touch) and pressure.

Lateral Spinothalamic Tract: The lateral spinothalamic tract is responsible for the transmission of signals for temperature and pain sensation.

Spinoreticular Tract: The spinoreticular tract plays a significant role in increasing the levels of alertness for pain and temperature sensations.

Spinotectal Tract: The spinotectal tract is responsible for the orientation of the eyes and movement of the head in response to the relevant stimulus.

Both anterior and lateral divisions of the spinothalamic tract pass next to each other and are often considered as a single pathway.

What Is the Clinical Significance of Spinothalamic Tract?

Any kind of spinal cord injury has a great impact on the spinothalamic tract.
Any lesion or injury in the spinothalamic tract would lead to the loss of temperature and pain sensations on one side of the body which lies opposite and below the site of the lesion.
Damage of the spinal cord that affects multiple tracts of the spinal cord including the spinothalamic tract characterized by paralysis or weakness on one side of the body and loss of sensation on the opposite side is known as Brown-Sequard syndrome.
A condition of the spinal cord that involves the formation of a cerebrospinal fluid-filled cyst within the spinal cord leading to loss of pain and temperature sensation on one or both sides of the body is known as syringomyelia.
Infarction (tissue death due to deficient blood supply to an affected area) of the spinal cord due to blockage of the anterior spinal artery results in the compromise of the spinothalamic tract. This in turn leads to bilateral loss of pain and temperature below the level of the lesion and the condition is known as anterior spinal artery syndrome.
Blockage of the posterior inferior cerebellar artery affects the spinothalamic tract and spinal trigeminal tract resulting in loss of pain and temperature sensations over the entire body (opposite side of the lesion) and one side of the face (same side of the lesion) respectively. This condition is known as lateral medullary syndrome.

What Are the Causes of Spinothalamic Injury?

The main cause of spinothalamic injury is traumatic and nontraumatic conditions affecting the spinal cord. They are as follows:

Motor vehicle accidents.
Stab and gunshot wounds.
Spinal fractures due to fall.
Spinal tumors.
Cervical spondylosis.
Herniated disc (slipped or bulged disc of the spinal cord).
Tuberculosis.
Radiation exposure.
Meningitis (swelling of the layers covering the brain and spinal cord).

What Are the Symptoms of Spinothalamic Injury?

Loss of sensation (mainly pain and temperature) on one or both sides of the body below the level of injury on the spinal cord.
Loss of muscle movement which may be seen as weakness or paralysis of one or both sides of the body.
Loss of bowel and bladder control.
Difficulty in walking.
Stiffness in the arms, legs, shoulders, and back.
Loss of balance.
Abnormal sensations like tingling or pricking on the arms and legs.
Numbness in arms and legs.

How to Diagnose Spinothalamic Damage?

The methods to diagnose spinothalamic damage are as follows:

Medical History and Physical Examination: The doctor takes detailed note of the medical history and symptoms experienced by the patient. The doctor also carries out a thorough physical examination to evaluate the motor (body movements to perform a particular task) and sensory (ability to identify touch, smell, hearing, vision, and taste) skills of the patient.

Magnetic Resonance Imaging (MRI): Magnetic resonance imaging scan uses large magnet, radio waves, and a computer to produce clear and detailed images of the structures and organs of the body. MRI of the spine is very useful in assessing the damage and abnormalities of the spinal cord.

Myelogram: A myelogram is an imaging test that uses a contrast dye and x-rays to obtain clear images of the spinal cord, vertebrae, discs, associated nerves, and nerve roots. This test is very beneficial in finding out the abnormalities in the spinal cord and its associated nerves which might cause weakness and numbness in the arms or legs.

Lumbar Puncture: Lumbar puncture is a test that is performed by inserting a needle in the lower back to obtain a sample of the cerebrospinal fluid. This test is useful in detecting conditions like tuberculosis, meningitis, and cancers of the spinal cord.

How to Treat Spinothalamic Damage?

The methods used in the treatment of spinothalamic damage mainly aim at treating spinal cord injuries. They are as follows:

Medications: People with spinal cord injuries, especially traumatic injuries, have a risk of developing blood clots. Hence medications like anticoagulants that prevent blood clot formation are given to the patients.

Surgery: In patients with non-traumatic causes involving severe spinal cord compression, surgery may be required to relieve the compression.

Neurogenic Bladder Management: In people experiencing loss of bladder control due to spinal cord damage, a urinary catheter, and other urological treatments may be recommended.

Temperature-Regulating Blankets: Spinothalamic damage may lead to loss of temperature regulation in patients. Hence doctors may recommend temperature-regulating blankets for such patients.

Physical Therapy and Occupational Therapy: Physical therapy involves exercises under the guidance of a physical therapist to treat abnormal physical functions due to any conditions or injuries. Physical therapy plays an important role in improving mobility and preventing further disability. Occupational therapy helps the patient to carry out the daily activities of life like walking, wearing clothes, and climbing stairs without any difficulties by getting adapted to the disability mentally and physically under the guidance of a therapist.

Conclusion

Spinothalamic damage can be a serious complication if left untreated. However, with the right treatment plan, most of the patients have regained normal physical functions. Hence early diagnosis followed by prompt treatment combined with exercises under the guidance of a trained therapist can help the patient lead a normal life.

Frequently Asked Questions

1. Are Spinal Hemangiomas Cancerous?

Spinal hemangiomas are typically non-cancerous growths in the spine's blood vessels. They are often benign and slow-growing tumors made up of excess blood vessels. While they can cause symptoms due to their location and size, they are generally not considered cancerous or malignant. Medical evaluation is important to determine the nature of the growth and the appropriate course of action for treatment, if necessary.

2. Is the Sensory Cortex's Location on the Right or Left Side of the Body?

The sensory cortex is located on both the right and left sides of the body. It is a region of the brain's cerebral cortex responsible for processing sensory information from various body parts. The sensory cortex's organization follows the "homunculus," where different body areas are represented in a specific spatial arrangement. The left sensory cortex processes sensory information from the right side of the body, and vice versa, due to the brain's contralateral organization.

3. How Does the Dorsal Column Differ from the Spinothalamic Tract?

The dorsal column and spinothalamic tract are two distinct pathways within the spinal cord that carry different types of sensory information. The dorsal column pathway primarily transmits tactile, proprioceptive, and fine touch sensations, while the spinothalamic tract carries information related to pain, temperature, and crude touch. Another key difference lies in their decussation (crossing over) points: the dorsal column pathway crosses over in the brainstem. In contrast, the spinothalamic tract crosses over shortly after entering the spinal cord. These pathways collectively enable the brain to process and interpret various sensory inputs from the body.

4. Which Tract Is Responsible for Rapid Nociceptive Transmission?

The spinothalamic tract is responsible for the rapid transmission of nociception, which refers to pain perception. This pathway swiftly conveys information about harmful or potentially damaging stimuli from the body to the brain for appropriate response and interpretation. Nociceptive signals are relayed through the spinothalamic tract, allowing the brain to assess and generate timely reactions to potentially harmful situations or injuries.

5. In Which Part of the Spinal Cord Is the Spinothalamic Tract Situated?

The spinothalamic tract is within the spinal cord's white matter, specifically in the lateral and anterior regions. This pathway runs vertically, transmitting sensory information related to pain, temperature, and crude touch from the body's periphery to higher brain centers. As it ascends through the spinal cord, the spinothalamic tract crosses over to the opposite side, ensuring that sensory information from one side of the body is processed in the contralateral hemisphere of the brain.

6. Define the Spinothalamic Pathway of Neurons.

The spinothalamic pathway of neurons refers to the neural circuitry responsible for transmitting sensory information related to pain, temperature, and crude touch from the body to the brain. Nociceptors and other sensory receptors in the skin and internal organs detect these stimuli and initiate signals that travel through the spinothalamic tract. These signals are relayed through a series of interconnected neurons, involving synapses in the spinal cord and thalamus, before reaching the somatosensory cortex in the brain for processing and perception of the sensations.

7. Explain the Function of the Anterior Spinothalamic Tracts.

The anterior spinothalamic tracts are neural pathways that transmit crude touch and pressure sensations from the body to the brain. These tracts run alongside the lateral spinothalamic tracts, which convey pain and temperature information. The anterior tracts are positioned more medially within the spinal cord's white matter. Together, these pathways enable the brain to perceive and differentiate various sensory inputs, contributing to our overall sensory experience and awareness of our environment.

8. What Is the Total Count of Spinal Tracts?

The number of spinal tracts varies depending on how they are categorized and classified. Generally, there are multiple sensory and motor tracts within the spinal cord, each serving a specific function. These tracts facilitate the transmission of sensory information from the body to the brain and convey motor commands from the brain to the body. While the exact count might differ based on how one categorizes different subtypes and pathways, numerous tracts collectively play a crucial role in our sensory perception and motor control.

9. What Are the Three Major Spinal Tracts?

The three major spinal tracts are the dorsal column-medial lemniscus pathway, the spinothalamic tract, and the corticospinal tract. These pathways are vital for relaying different types of sensory and motor information between the body and the brain. The dorsal column-medial lemniscus pathway carries tactile, proprioceptive, and fine touch sensations. The spinothalamic tract conveys pain, temperature, and crude touch signals. The corticospinal tract is responsible for voluntary motor control, allowing the brain's commands to reach muscles and orchestrate movement.

10. Can You Provide the List of the 21 Pairs of Spinal Nerves?

There are 31 pairs of spinal nerves in the human body, each emerging from specific spinal cord segments. These nerves are categorized into cervical, thoracic, lumbar, sacral, and coccygeal regions. The spinal nerves connect the central nervous system to various body parts, facilitating sensory perception and motor control. They enable the transmission of sensory information from the body to the spinal cord and brain and convey motor commands from the brain to muscles and glands.

11. At What Point Does the Spinomesencephalic Tract Cross Over (Decussate)?

The Spinomesencephalic tract, also known as the Spinotectal tract, crosses over (decussates) in the spinal cord shortly after its entry. This crossing occurs in the anterior white commissure of the spinal cord, which allows sensory information related to pain and temperature to switch from one side of the body to the opposite side of the brain. From this point, the tract ascends to the midbrain's tectum, contributing to the brain's processing of pain and other sensory signals.

12. What Leads to Damage of the Spinothalamic Tract?

Damage to the spinothalamic tract can result from various factors, such as spinal cord injuries, trauma, infections, or neurological disorders. When this tract is damaged, it can lead to impaired perception of pain, temperature, and crude touch sensations. Due to its contralateral organization, individuals might experience reduced or altered sensations related to these stimuli on the side of the body opposite to the damaged tract. The severity and specific symptoms can vary based on the extent and location of the damage within the spinal cord.

13. What Kind of Symptoms Arise from Damage to the Dorsal Column?

If the dorsal column of a spinal nerve is damaged, it can disrupt sensory processing. Dorsal columns primarily carry fine touch, proprioception, and vibration sensations. Damage to these pathways can lead to sensory deficits such as decreased ability to perceive touch, inability to sense limb positions, and reduced sensitivity to vibrations. Depending on the extent of the injury, these sensory impairments can impact an individual's motor coordination, spatial awareness, and overall sensory perception. Rehabilitation and medical intervention may be necessary to manage and mitigate the effects of such damage.

14. What Are the Consequences of Severing a Dorsal Root of a Spinal Nerve?

Compression of a dorsal root of a spinal nerve can lead to a range of sensory and motor symptoms. These symptoms depend on the specific nerves affected and their corresponding functions. Common signs of dorsal root compression include pain, numbness, tingling, and weakness in the areas supplied by the compressed nerve. The affected individual might also experience altered reflexes and sensory perception abnormalities. Timely medical evaluation and treatment are crucial to address the underlying cause of compression and effectively manage the resulting symptoms.

15. How Do Symptoms of Dorsal Root Compression Manifest?

The symptoms arising from dorsal root compression can manifest as pain, numbness, and sensory disturbances in the regions of the body connected to the compressed nerve. This can include feelings of tingling, burning sensations, and general discomfort. Motor functions may also be affected, leading to muscle weakness and difficulties with coordination. Reflexes related to the compressed nerve might become hyperactive or diminished. Addressing the root cause of the compression through medical intervention and physical therapy can help alleviate these symptoms and restore normal nerve function.

Sources

Dr. Prakashkumar P Bhatt

Neurology

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