In internal capsule hemorrhage, superficial sensation loss occurs because the fibers carrying pain and temperature sensations (spinothalamic tract) are located more laterally, while deep sensation fibers (proprioception and vibratory sense) are more medially positioned. The hemorrhage often affects the lateral portion of the internal capsule, leading to a loss of superficial sensory modalities while sparing the deeper sensations. Additionally, the organization of the internal capsule means that lesions typically disrupt the pathways for superficial sensations before impacting deep sensation pathways.
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