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Library of Congress Cataloging-in-Publication Data
Anatomic basis of neurologic diagnosis / Cary D. Alberstone [et al.].
p.; cm.
Includes bibliographical references and index.
ISBN 978-0-86-577976-1 (alk. paper)
1. Neurologic examination. 2. Neuroanatomy. I. Alberstone, Cary D.
[DNLM: 1. Diagnostic Techniques, Neurological. 2. Central Nervous Systemanatomy & histology. WL 141 A535 2009]
RC348.A53 2009
616.80475dc22
2008035366
Copyright 2009 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher's consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage.
Important note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information. Readers are encouraged to confirm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.
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Printed in China
5 4 3 2 1
ISBN 978-0-86-577976-1
To my wife, Lisa: Thank you for your patience and your friendship.
And to my children, Lauren and Adam: The nervous system is an extraordinary asset; use yours to the utmost.
Cary Alberstone
I dedicate this book to Mrs. Benzel (Mary, my wife) for her unending love and support of my craziness and to our children (Morgan, Jason, Brian, and Matthew) for their tolerance and their commitment to the team we call family.
Ed Benzel
To my wife, Tania, whose continuous support allowed me to work on this book, and to my children, Elias, Joseph and Maya, who make our efforts all worthwhile.
Imad Najm
I dedicate this book to my wife, Bettina, and my children, Cameron and Marcus, for their unending love and support. My family continuously reminds me why we undertake such endeavors.
Michael Steinmetz
Contents
Foreword
The authors of this volume are a world-class group of clinical neuroscientists from one of the world's greatest medical centers. They have done a masterful job of integrating basic anatomy and neurologic diagnosis based on the patient's signs and symptoms. This is the best book I have seen on the correlation between neuroanatomy and clinical findings during my more than 40 years of clinical practice. In 23 chapters, beginning with neuroembryology and ending with cerebrospinal fluid, they have covered the full spectrum of regional and system-based neuroanatomy, related syndromes, and differential diagnosis. The presentation of each topic is concise, but it is comprehensive in its overall coverage of neurologic diagnosis. The text in each chapter is supplemented with color illustrations showing the anatomic basis of the patient's signs and symptoms. Students and trainees will benefit from studying this book from cover to cover, and clinicians with advanced knowledge and experience will use it frequently for quick reference.
Albert L. Rhoton Jr., MD
R.D. Keene Family Professor
Professor and Chairman Emeritus
Department of Neurosurgery
University of Florida
Preface
This book is intended for medical students, residents, and practicing clinicians who wish to understand or review the basic anatomic concepts that underlie neurologic diagnosis. The book explains the fundamentals of neuroanatomy and illustrates their clinical application. In keeping with this philosophy, this book emphasizes principles and clinically relevant facts: anatomic details with little or no clinical import are discussed briefly or omitted so as to concentrate on the essentials of neurologic diagnosis.
This fund of knowledge is organized as the clinical neurologist would organize it: by regions and functional systems. Thus, after an introductory chapter on neuroembryology (Part I), Part II of the book comprises a series of chapters on the anatomy of regional parts of the nervous system, including peripheral nerves, plexuses, nerve roots and spinal nerves, spinal cord, brainstem, cranial nerves, cerebellum, thalamus, hypothalamus, basal ganglia, limbic system, and cerebral cortex. These chapters are divided into two sections: the first section describes the basic anatomy of the region, the second section discusses the region's cardinal manifestations in disease.
Part III comprises a series of chapters on functional systems. These include the somatosensory system, visual system, auditory system, vestibular system, ocular motor system, motor system, autonomic system, and consciousness. These chapters are divided into two sections: the first section describes the basic anatomy of the system, the second section describes a practical approach to the patient with a system disorder. Part IV comprises a chapter on the vascular system and a chapter on the cerebrospinal fluid.
To complement and amplify the text we have illustrated the book lavishly with original drawings that convey anatomic and clinical concepts. These unique drawings are rendered so as to illustrate structure, function, and dysfunction in a single view. Thus each drawing illustrates the clinical deficit associated with a described structure, or, conversely, a structure that produces a described clinical deficit.
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