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Published online by Cambridge University Press: 22 November 2024
The pyramidal decussation is located in the inferior medulla, the lowest portion of the brainstem. Here, the axons of the corticospinal tract cross (decussate); this is the reason why the right brain controls the left half of the body, and the left brain controls the right. The anatomy of the corticospinal fibers in this region is complicated. The fibers destined for upper extremity are traveling more medially and anteriorly compared to those destined for lower extremity. In addition, the decussation of the upper extremity corticospinal fibers occurs above the level of the foramen magnum, and that of lower extremity fibers occurs inferiorly.
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