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 )

12. THANK YOU