Sudden sensory ataxia with posterior spinal artery territory infarct

A 66-year-old man with long-standing hypertension and hyperlipidemia presents with sudden onset difficulty walking after waking up. He says his right leg “doesn’t know where it is” and he keeps looking down to place his foot. He denies pain. On neurologic exam, strength is 5/5 in all extremities. Pinprick and temperature sensation are intact throughout. Vibration and joint-position sense are decreased in the right lower extremity below the umbilicus. When his eyes are closed, he sways markedly while standing. MRI suggests a small infarct involving a posterior spinal artery territory at approximately T10 on the right. Which of the following best describes the laterality of the major sensory deficit expected from this lesion?

(Assume the lesion is confined to the spinal cord and does not involve the brainstem.)

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