CONTENTS
Preface vii
1 GROSS STRUCTURE OF THE BRAIN 1
I Divisions of the Brain 1
2 DEVELOPMENT OF THE NERVOUS SYSTEM 10
I The Neural Tube 10
II The Neural Crest 10
III The Cranial Neuropore 12
IV The Caudal Neuropore 12
V Microglia 12
VI Myelination 12
VII The Optic Nerve and Chiasma 12
VIII The Hypophysis (pituitary gland) 12
IX Congenital Malformations of the CNS 13
3 NEUROHISTOLOGY 17
I Neurons 17
II Nissl Substance 17
III Axonal Transport 17
IV Anterograde (Wallerian) Degeneration 18
V Chromatolysis 18
VI Regeneration of Nerve Cells 18
VII Neuroglia 19
VIII The Blood–Brain Barrier 19
IX The Blood–CSF Barrier 19
X Pigments and Inclusions 20
XI Classification of Nerve Fibers 21
XII Tumors of the CNS and PNS 21
XIII Cutaneous Receptors 23
4 BLOOD SUPPLY 25
I The Spinal Cord and Caudal Brainstem 25
II The Internal Carotid System 25
III The Vertebrobasilar System 27
IV The Blood Supply of the Internal Capsule 28
V Veins of the Brain 28
VI Venous Dural Sinuses 29
VII Angiography 29
VIII The Middle Meningeal Artery 29
5 MENINGES, VENTRICLES, AND
CEREBROSPINAL FLUID 36
I Meninges 36
II Ventricular System 38
III Cerebrospinal Fluid 39
IV Herniation 39
6 SPINAL CORD 44
I Gray and White Rami Communicans 44
II Spinal Nerves 44
III Conus Medullaris 44
IV Location of the Major Motor and Sensory Nuclei of the Spinal Cord 45
V The Cauda Equina 47
VI The Myotatic Reflex 47
Case 6-1 49
I Posterior (Dorsal) Column—Medial Lemniscus Pathway 49
II Anterolateral System 51
III Lateral Corticospinal Tract 51
Case 6-2 54
I Diseases of the Motor Neurons and Corticospinal Tracts 54
II Sensory Pathway Lesions 55
III Combined Motor and Sensory Lesions 55
IV Peripheral Nervous System (PNS) Lesions 57
V Intervertebral Disk Herniation 57
VI Cauda Equina Syndrome (Spinal Roots L3 to C0) 57
VII Conus Medullaris Syndrome (Cord Segments S3 to C0) 58
7 BRAINSTEM 59
I Introduction 59
II Cross Section Through the Caudal Medulla 59
III Cross Section Through the Mid-Medulla 59
IV Cross Section Through the Rostral Medulla 61
V Cross Section Through the Caudal Pons 62
VI Cross Section Through the Mid-Pons 63
VII Cross Section Through the Rostral Pons 63
VIII Cross Section Through the Caudal Midbrain 64
IX Cross Section Through the Rostral Medulla 64
X Corticonuclear Fibers 64
Lesions of the Brainstem 65
I Lesions of the Medulla 65
II Lesions of the Pons 65
III Lesions of the Midbrain 66
IV Acoustic Neuroma (Schwannoma) 67
V Jugular Foramen Syndrome 67
VI “Locked-in” Syndrome 68
VII Central Pontine Myelinolysis 68
VIII “Top of the Basilar” Syndrome 68
IX Subclavian Steal Syndrome 68
X The Cerebellopontine Angle 68
8 AUTONOMIC NERVOUS SYSTEM 70
I Introduction 70
II Cranial Nerves (CN) With Parasympathetic Components 71
III Communicating Rami 73
IV Neurotransmitters 73
V Clinical Correlation 73
9 CRANIAL NERVES 75
I The Olfactory Nerve 75
II The Optic Nerve (CN II) 75
III The Oculomotor Nerve (CN III) 76
IV The Trochlear Nerve (CN IV) 77
V The Trigeminal Nerve (CN V) 78
VI The Abducent Nerve (CN VI) 80
VII The Facial Nerve (CN VII) 80
VIII The Vestibulocochlear Nerve (CN VIII) 82
IX The Glossopharyngeal Nerve (CN IX) 83
X The Vagal Nerve (CN X) 84
XI The Accessory Nerve (CN XI) 85
XII The Hypoglossal Nerve (CN XII) 85
10 TRIGEMINAL SYSTEM 87
I Introduction 87
II The Trigeminal Ganglion 87
III Trigeminothalamic Pathways 88
IV Trigeminal Reflexes 89
V The Cavernous Sinus 90
11 DIENCEPHALON 92
I Introduction 92
II The Thalamus 92
III Blood Supply 94
IV The Internal Capsule 94
V The hypothalamus 95
12 AUDITORY SYSTEM 100
I Introduction 100
II The Auditory Pathway 100
III Hearing Defects 102
IV Auditory Tests 102
13 VESTIBULAR SYSTEM 104
I Introduction 104
II The Labyrinth 104
III The Vestibular Pathways 104
IV Vestibulo-ocular Reflexes 106
14 VISUAL SYSTEM 108
I Introduction 108
II The Visual Pathway 108
III The Pupillary Light Reflex Pathway 111
IV The Pupillary Dilation Pathway 111
V The Near Reflex and Accommodation Pathway 112
VI Cortical and Subcortical Centers for Ocular Motility 113
VII Clinical Correlation 114
15 LIMBIC SYSTEM 116
I Introduction 116
II Major Components 116
III The Papez Circuit 116
IV Clinical Correlations 118
16 BASAL NUCLEI AND EXTRAPYRAMIDAL
MOTOR SYSTEM 120
I Basal Nuclei (Ganglia) 120
II The Extrapyramidal (Striatal) Motor System 120
III Clinical Correlation 121
17 CEREBELLUM 126
I Function 126
II Anatomy 127
III The Deep Cerebellar Nuclei 128
IV The Major Cerebellar Circuit 128
V Cerebellar Dysfunction 129
VI Cerebellar Syndromes and Tumors 129
18 CEREBRAL CORTEX 131
I Introduction 131
II The Six-Layered Neocortex 131
III Functional Areas 132
IV Focal Destructive Hemispheric Lesions and Symptoms 135
V Cerebral Dominance 135
VI Split Brain Syndrome 137
VII Other Lesions of the Corpus Callosum 138
VIII Brain and Spinal Cord Tumors 138
IX Apraxia 138
X Aphasia 139
XI Dysprosodies 140
19 CROSS-SECTIONAL ANATOMY OF THE BRAIN 142
I Introduction 142
20 NEUROTRANSMITTERS 161
I Major Neurotransmitters 161
II Functional and Clinical Considerations 165
Appendix I: Table of Cranial Nerves 167
Appendix II: Table of Common Neurological Disease States 170
Glossary 173
Index 183