Vishram Singh - Textbook of Clinical Neuroanatomy
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Second Edition
Vishram Singh, MS
Professor & Head, Department of Anatomy, Professor-in-charge, Medical Education Unit, Additional Senior Superintendent of Examination, Santosh Medical College, Santosh University, Ghaziabad, NCR, Delhi
Textbook of Clinical Neuroanatomy, 2/e
Vishram Singh
Elsevier
A division of
Reed Elsevier India Private Limited
Mosby, Saunders, Churchill Livingstone, Butterworth Heinemann and Hanley & Belfus are the Health Science imprints of Elsevier.
2010 Elsevier
First published 2004
Reprinted 2005 (twice), 2006, 2007,
2008 (thrice), 2009 (thrice)
Second Edition 2010
All rights are reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher.
ISBN: 978-81-312-2307-9
Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The authors, editors, contributors and the publishers have, as far as it is possible, taken care to ensure that the information given in this text is accurate and up-to-date. However, readers are strongly advised to confirm that the information, especially with regard to drug dose/usage, complies with current legislation and standards of practice.
Published by Elsevier, a division of Reed Elsevier India Private Limited
Registered Office: Gate No. 3, Shed A-1, 2 Industrial Area, Kalkaji, New Delhi-110 019. Sales and Publishing Office: 14th Floor, Building No. 10B, DLF Cyber City, Phase-II, Gurgaon 122002, Haryana, India.
Head, Medical Education: Jalees Farhan
Managing Editor: Binny Mathur
Copy Editor: Goldy Bhatnagar
Manager Publishing Operations: Sunil Kumar
Manager Production: NC Pant
Typeset by Olympus Infotech Pvt. Ltd., Chennai, India.
Printed and bound at Ajanta Offset, New Delhi.
Dedicated to My Parents
It is with great pleasure that I express my gratitude to all the students and teachers of the Indian subcontinent who have whole heartedly appreciated and recommended this book. It is because of their support that this book was reprinted more than 10 times since its first publication in 2004.
The success of this book reflects the appeal of its unique problem-solving approach and its utility in highlighting the anatomical and embryological basis of clinical problems in neurology and neurosurgery. This approach has been retained in this edition.
Based on the large number of suggestions by the teachers of anatomy (my young colleagues and senior Professors) and students, the text has been thoroughly updated and a number of new illustrations, tables and flowcharts have been added for easy comprehension and assimilation of the complicated information. The topics on cranial nerves, blood supply of the brain and sensory and motor pathways have been described in detail due to high incidence of cranial nerve lesions, cerebrovascular accidents and sensory and motor disorders in recent times.
There was a growing demand from PG students, neurologists and neurosurgeons to provide actual photographs, CT scans and MR images to appreciate the value of current diagnostic imaging techniques in diagnosing neurological lesions. They have been especially commissioned for this edition from Gray's Anatomy for Students, Integrated Anatomy, Davidson's Principles and Practice of Medicine (with kind permission of the publisher).
While the text is primarily written to help the undergraduate medical students to clear their concepts of neuroanatomy and confidently answer the questions in examinations, I am sure PG students, neurologists and neurosurgeons will also find it of value in updating and refreshing their knowledge.
I am really overwhelmed with the unexpected success of this book and for this I thank from the bottom of my heart (cortical) all students and academics. The inspiration and encouragement provided by them helped me to complete this revision. I sincerely hope that they will find this edition even more interesting and useful than the previous one. I would highly appreciate their comments and suggestions for further improvement of this book.
Inspiring students to success is teacher's success
Vishram Singh
During my long teaching experience, I found that undergraduate medical students generally feel that neuroanatomy is not only a difficult subject to understand but also that it is not of much help in general practice. Contrary to this view, I feel that the subject of neuroanatomy is based on sound scientific foundation, which if properly understood, is of great clinical importance even for general practice in addition to neurological specializations.
To ensure that students develop an interest in neuroanatomy, this book is written in simple language with rational ideas and correlation of theoretical knowledge to clinical problems. Further the text is profusely illustrated which makes it easier for students to understand the subject and correlate their knowledge rather than merely memorizing the information.
As a teacher of Anatomy, I am emphatic that nothing stimulates the students more than discussing clinical applications of neuroanatomy. Therefore theoretical details, not of much clinical relevance have been skipped; on the other hand emphasis is given on problem-based learning (PBL). Clinical comments (screened in light pink) are inserted in the running text itself to emphasize the clinical significance of every segment of the text. Patient-oriented problems and their anatomical basis are presented at the end of each chapter.
I hope that this textbook will be useful and exciting to read and that it will stimulate enthusiasm for the subject.
It is my pleasure to sincerely thank all my colleagues in the department, Dr. Poonam Kharb, Dr. Nisha Kaul, Dr. LK Padhy and Dr. Rajvir Singh for their help during the preparation of this book. I am highly grateful to my teacher Prof A Halim who inspired me to develop a keen interest in neuroanatomy.
I express my gratitude to Professors/Doctors Ashok Sahai, Ajai Srivastava, PK Sharma and Mehdi Hasan (Lucknow); Hasan Zaidi, Virendra Kumar, Vinod Kumar and RK Srivastava (Kanpur); NC Goel and Manju Goel (Allahabad); Usha Dhall and SK Srivastava (Rohtak); Rani Kumar, Gayatri Rath, ZM Kaul, RK Suri, ML Ajmani, Ram Prakash and Veena Bharihoke (New Delhi); SJ Haider and Nafis Ahmad Faruqi (Aligarh); Ramesh Babu (Meerut); Versha Katira (Ghaziabad), Krishna Garg and Brijendra Singh (Murad Nagar); Madhur Gupta and Balbir Singh (Chandigarh); SL Jethani and Sohail A Pervez (Jolly Grant, Dehradun); A Agarwal (Agra) for their support.
I am deeply indebted to Mr. MM Mehra of BI Publications for providing me books for reference during the preparation of this text. My thanks are due to Mr. Atul Bhushan for typesetting and page designing. I highly appreciate the perseverance and keen interest shown by Mr. Aslam Pervez in redrawing the illustrations on the computer.
I wish to express my thanks to Mr. YR Chadha, Publishing Consultant, BI Publications, and to the staff of Elsevier, particularly Mr. Rajiv Banerji, Publishing Manager, Mr. Anand K Jha, Editor, and Mr. NC Pant, Senior Production Executive for taking keen interest in production of this book. The efforts of Mr. Jha have been invaluable for completion of this project.
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