Megaloblastic Anemia · Pathology

A patient with Vitamin B12 deficiency presents with 'Subacute Combined Degeneration' of the spinal cord. Which tracks are primarily involved?

  1. Anterior horn cells and spinothalamic tract
  2. Dorsal columns and corticospinal tracts
  3. Cerebellar peduncles
  4. Basal ganglia
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Correct answer: Dorsal columns and corticospinal tracts

B12 deficiency leads to the accumulation of methylmalonic acid, which is toxic to myelin. This causes demyelination of the posterior (dorsal) columns and the lateral corticospinal tracts, leading to loss of vibration sense and spasticity.

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