Kenneth W. Lindsay - Neurology and Neurosurgery Illustrated

Kenneth W. Lindsay PhD FRCS

Formerly Consultant Neurosurgeon, Institute of Neurological Sciences, Southern General Hospital, Glasgow

Ian Bone FRCP FACP

Formerly Consultant Neurologist, Institute of Neurological Sciences, Southern General Hospital, Glasgow; Honorary Clinical Professor, University of Glasgow, Glasgow, UK

Geraint Fuller MD FRCP

Consultant Neurologist, Department of Neurology, Gloucester Royal Hospital, Gloucester, UK

Illustrated by

Robin Callander FFPh FMAA AIMBI

Medical Illustrator, Formerly Director of Medical Illustration, University of Glasgow, Glasgow, UK

Foreword by

J. van Gijn MD FRCPE

Emeritus Professor of Neurology, Utrecht, The Netherlands

FIFTH EDITION

EDINBURGH LONDON NEW YORK OXFORD PHILADELPHIA ST LOUIS SYDNEY TORONTO 2011

Commissioning Editor: Timothy Horne

Senior Development Editor: Ailsa Laing

Project Manager: Nancy Arnott

Designers: Erik Bigland, Jim Farley

Copyright

CHURCHILL LIVINGSTONE ELSEVIER

2010 Elsevier Ltd. All rights reserved.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publishers permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

First edition 1986

Second edition 1991

Third edition 1997

Fourth edition 2004

Fifth edition 2010

ISBN 978-0-443-06957-4

International ISBN 978-0-443-06978-9

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress

Notices

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.

With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

Printed in China

FOREWORD

Students often tend to regard diseases of the nervous system as a difficult subject. This book has surely dispelled that traditional belief, as testified by the success of the four previous editions, spanning almost a quarter of a century. The authors have managed to make the nervous system and its disorders accessible in several ways. First and foremost, they have used every possible opportunity to include illustrations, especially simple line drawings, whenever the subject allowed it. In this way the structure and functions of the nervous system, baffling at first sight, are lucidly explained, part by part. Thanks to their didactic guidance, the student will eventually find the matter less complicated than the street map of inner London. Secondly, the text has been restricted to bare essentials. Students do not have to wade through a wilderness of words in order to grasp the key elements they need to know. Finally, between the traditional signposts of physical examination, technical investigations and traditional disease categories, the authors have made ample room for a didactic discussion of the variety of symptoms that bring patients to the neurologist or neurosurgeon - from loss of smell to problems of memory. After all, the patient is the point of departure in medicine. Like a convenient travel guide that leads the tourist to memorable sights, the book will teach the student and remind the physician - how to understand, recognize and treat disorders of the brain, spinal cord, nerves and muscle. In this fifth edition the authors have taken account of new developments, while preserving the admirable clarity and simplicity that make it stand out from other textbooks.

J. van Gijn, MD FRCP FRCP(Edin) , Emeritus Professor of Neurology, Utrecht, The Netherlands

An accurate description of the patients neurological symptoms is an important aid in establishing the diagnosis; but this must be taken in conjunction with information from other systems, previous medical history, family and social history and current medication. Often the patients history requires confirmation from a relative or friend.