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Corticospinal Tract
                    Syndrome
           ( Pyramidal tract syndrome )



Presented by :
Ahmed Abdullatif Al Awwad
208002865
Objectives ..
• Introduction
• Anatomy of corticospinal tract
• Corticospinal tract syndrome
 ▫ Causes
 ▫ Assessment
 ▫ Treatment
Introduction ..
• Fibers of the corticospinal
  tract arise as axons of
  pyramidal cells in the fifth
  layer of the cortex.
• It conducts motor impulses
  from the brain to the spinal
  cord where somatic motor
  neurons conduct impulses
  to various skeletal muscle
  effectors.
Anatomy ..
• The descending fibers
  originated     in    the
  primary motor cortex
  pass via the corona
  radiata and then pass
  through the interior
  capsule.
• On entering the pons,
  the tract is broken into
  many bundles.
Anatomy ..
• In the medulla oblongata,
  the    bundles    become
  grouped together to form
  swelling    known      as
  pyramid.
Anatomy ..
• At the junction of the
  medulla oblongata and
  spinal cord, most of
  fibers cross the midline
  at the decussation of
  the    pyramids       and
  enter the lateral white
  column of the spinal cord
  to form the lateral
  corticospinal tract.
Anatomy ..
• The remaining fibers do
  not     cross    in   the
  decussation but descend
  in the anterior white
  column of the spinal cord
  as      the     anterior
  corticospinal tract.
• The lateral corticospinal
  tract descends the length
  of the spinal cord; its
  fibers terminate in the
  anterior gray column of
  the    all  spinal   cord
  segments.
Corticospinal tract syndrome ..
• It’s known as upper motor neuron
  syndrome.
• This syndrome will change the motor control of
  skeletal muscles.
• The changes vary depending on the site and the
  extent of the lesion.
Causes of Corticospinal tract syndrome ..

• Stroke

• Multiple sclerosis

• Traumatic spinal injury

• Cerebral palsy

            Leading to many changes ..
Corticospinal tract syndrome ..
• The changes may includes:
 ▫ Muscle weakness
 ▫ Decrease motor control including decrease speed
   and accuracy
 ▫ Spasticity
 ▫ Babinski sign and Ankle clonus is present
 ▫ Deep tendon reflexes are increased or present
 ▫ Clasp-knife response ( initial higher resistance to
   movement is followed by a lesser resistance )
Corticospinal tract syndrome ..
• Treatment :
 ▫ Physiotherapy ( exercise, serial
   casts, flexibility exercises, … )
 ▫ Equipments that help
   in movement
 ▫ Medical intervention
   ( baclofen, diazepam,
   dantrolene, phenol
   injections )
THANK YOU

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Corticospinal tract syndrome

  • 1. Corticospinal Tract Syndrome ( Pyramidal tract syndrome ) Presented by : Ahmed Abdullatif Al Awwad 208002865
  • 2. Objectives .. • Introduction • Anatomy of corticospinal tract • Corticospinal tract syndrome ▫ Causes ▫ Assessment ▫ Treatment
  • 3. Introduction .. • Fibers of the corticospinal tract arise as axons of pyramidal cells in the fifth layer of the cortex. • It conducts motor impulses from the brain to the spinal cord where somatic motor neurons conduct impulses to various skeletal muscle effectors.
  • 4. Anatomy .. • The descending fibers originated in the primary motor cortex pass via the corona radiata and then pass through the interior capsule. • On entering the pons, the tract is broken into many bundles.
  • 5. Anatomy .. • In the medulla oblongata, the bundles become grouped together to form swelling known as pyramid.
  • 6. Anatomy .. • At the junction of the medulla oblongata and spinal cord, most of fibers cross the midline at the decussation of the pyramids and enter the lateral white column of the spinal cord to form the lateral corticospinal tract.
  • 7. Anatomy .. • The remaining fibers do not cross in the decussation but descend in the anterior white column of the spinal cord as the anterior corticospinal tract. • The lateral corticospinal tract descends the length of the spinal cord; its fibers terminate in the anterior gray column of the all spinal cord segments.
  • 8. Corticospinal tract syndrome .. • It’s known as upper motor neuron syndrome. • This syndrome will change the motor control of skeletal muscles. • The changes vary depending on the site and the extent of the lesion.
  • 9. Causes of Corticospinal tract syndrome .. • Stroke • Multiple sclerosis • Traumatic spinal injury • Cerebral palsy Leading to many changes ..
  • 10. Corticospinal tract syndrome .. • The changes may includes: ▫ Muscle weakness ▫ Decrease motor control including decrease speed and accuracy ▫ Spasticity ▫ Babinski sign and Ankle clonus is present ▫ Deep tendon reflexes are increased or present ▫ Clasp-knife response ( initial higher resistance to movement is followed by a lesser resistance )
  • 11. Corticospinal tract syndrome .. • Treatment : ▫ Physiotherapy ( exercise, serial casts, flexibility exercises, … ) ▫ Equipments that help in movement ▫ Medical intervention ( baclofen, diazepam, dantrolene, phenol injections )