Neuroanatomy for the Neuroscientist (eBook)

Neuroanatomy for the Neuroscientist 9
Part1: Essential Organization of the Central Nervous System 25
1: Introduction to the Nervous System 26
The Neuron 26
The Nervous System 29
Peripheral Nervous System 29
Central Nervous System 29
Spinal Cord 29
Brain 29
Brain Stem 29
Cerebellum 31
Diencephalon (Fig.  1.5) 32
Cerebrum Cerebral Hemispheres (Fig.  1.7) 33
Functional Localization 34
Cortical White Matter 34
Basal Ganglia (Chap. 12) 35
Central Nervous System Pathways 36
The Motor-Sensory Cortex (Fig.  1.7) 36
Case History 1.1 (Fig.  1.10) 37
Glands Associated with the Brain 38
References 38
Suggested Readings 38
2: Neurocytology 39
The Neuron 39
Dendrites 39
Soma 39
Golgi Type I and II Neurons 39
Dendritic Spines (Fig.  2.2) 40
Cytoplasm Organelles 42
Nucleus 42
Rough Endoplasmic Reticulum or Nissl Body (Figs.  2.5 and 2.6) 42
Mitochondria (Figs.  2.10 – 2.12) 43
Neurosecretory Granules 44
Neuronal Cytoskeleton 44
Microtubules and Axoplasmic Flow 45
Neurofibrillar Tangles 45
Axon and Axon Origin (Axon hillock) (Fig.  2.9) 46
Myelin Sheath: The Insulator in an Aqueous Media (Fig.  2.10) 46
Myelination: Schwann Cell in PNS and Oligodendrocyte in CNS 47
Central Nervous System Pathways 47
Synapse 48
Synaptic Structure 48
Synaptic Types 49
Synaptic Transmission 49
Neurotransmitters (Table  2.3) 49
Modulators of Neurotransmission 49
Synaptic Vesicles (Table  2.4) 49
Synaptic Types (Fig.  2.14) 50
Effectors and Receptors 50
Supporting Cells of the Central Nervous System 50
Astrocytes (Figs.  2.4 , 2.13 Table  2.7)52
Oligodendrocytes (Fig.  2.5) 52
Endothelial Cells 53
Mononuclear Cells: Monocytes and Microglia 53
An Immunologically Privileged Site? 53
Ependymal Cells (Fig.  2.17) 55
Supporting Cells in the Peripheral Nervous System 55
Response of Nervous System to Injury 56
Degeneration 56
Regeneration 56
Peripheral Nerve Regeneration 56
Regeneration in the Central Nervous System 58
Stem Cells. A Source of Replacement for Damaged Neurons? 58
Nerve Growth Factors 58
Glial Response to Injury 58
Blood-Brain Barrier 59
Blood-Brain Barrier (Fig.  2.21) 59
Extracellular Space 60
References 60
Suggested Reading 62
3: Neuroembryology and Congenital Malformations 64
Introduction 64
Formation of the Central Nervous System 64
Neural Crest Cells 64
Histogenesis 65
Repair of Damaged Nervous System 66
Principles of Differentiation Within the CNS 66
Growth Cone Guidance 66
Programmed Cell Death 66
Neuronal Death 67
Development of Blood Vessels in the Brain 67
Development of Ventricular System 67
Formation of Peripheral Nervous System 68
Spinal Cord Differentiation: Origin of the Spinal Cord 68
Brain Differentiation 69
Rhombencephalon (Hind Brain) 69
Mesencephalon 70
Prosencephalon 71
Diencephalon 71
Cranial Nerves 71
Cranial Nerve Innervation for Muscles of Somite Origin 72
Cranial Nerves Innervating Muscles (Skeletal) and Skin in the Pharyngeal Arches 72
Preganglionic Parasympathetic Innervation to Smooth Muscle 73
Cranial Nerves Associated with the Special Senses 73
Prenatal Development of Cerebral Cortex 74
Neuronal Migration 76
Changes in Cortical Architecture as a Function of Postnatal Age 76
Neuronal Maturation 77
Abnormal Development 78
Malformations Resulting from Abnormalities in Growth and Migration with Incomplete Development of the Brain 79
Genetically Linked Migration Disorders 79
Bibliography 83
4: Spinal Cord with Atlas of Spinal Cord 84
Gross Anatomy 84
Spinal Cord: Structure and Function 84
Nerve Roots 85
Gray Matter 86
Laminar Organization of Central Gray (Fig.  4.6) 87
Interneurons 88
Segmental Function 89
Motor/Ventral Horn Cells 89
Sensory Receptors 90
Stretch Receptors 91
Nociception and Pain 92
Modulation of Pain Transmission 93
White Matter Tracts 94
Descending Tracts in the Spinal Cord 94
Ascending Tracts in the Spinal Cord 95
The Anterolateral Pathway 95
III. Upper and Lower Motor Neurons Lesions 97
A. Upper Motor Neuron Lesion (UMN) 97
B. Lower Motor Neuron Lesion 99
IV. Spinal Cord Case Histories 99
Case History 4.1 99
Case History 4.2 100
Atlas Spinal Cord (Figs.  4.18 – 4.21) 100
References 103
Suggested Readings 103
5: Brain Stem Gross Anatomy 105
Introduction 105
Gross Anatomical Divisions 105
Sites of Transition 105
Relationship of Regions in the Brain to the Ventricular System (Fig.  5.2) 106
Gross Anatomy of Brain Stem and Diencephalon 106
Anterior Surface of Gross Brain Stem (Fig.  5.3) 106
Medulla and Pons 106
Anterior Surface Midbrain 108
Posterior Surface of Brain Stem and Diencephalon (Fig.  5.4) 108
Medulla and Pons Posterior Surface (Fig.  5.4) 108
Midbrain Posterior Surface 110
Diencephalon: Ventral and Posterior Surfaces 110
Arterial Blood Supply to the Brain Stem and Diencephalon (Fig.  5.5) 111
Medulla 111
Pons 111
Midbrain 112
Diencephalon 112
References 112
6: Brain Stem Functional Localization with Atlas of the Brain Stem 113
Tegmentum 113
Differences Between the Spinal Cord and Brain Stem 113
Functional Localization in Brain Stem Coronal Sections and an Atlas of the Brainstem 113
Medulla 114
Blood Supply: Branches from the Vertebral Artery 114
Brain Stem Level One: Medulla at Transition Between Cervical Spinal Cord and Low Medulla: Motor-Sensory Decussation (Fig.  6.2 Coronal) 114
Brain Stem Level Two: Brain Stem at Narrow Medulla 115
Ventricular Zone 115
Lateral Zone 116
Medial Zone 117
Central Zone 118
Brain Stem Level Three: Brain Stem at Wide-Medullary Level 118
Ventricular Zone 118
Lateral Zone 118
Pons 118
Blood Supply: Basilar Artery and Its Branches 118
Brain Stem Level Four: Pons at Facial Colliculus (Fig.  6.5) 120
Ventricular Zone 120
Lateral Zone 121
Medial Zone 121
Basilar Zone (Fig.  6.5b) 121
Brain Stem Level Five: Upper Pons at the Motor and Main Sensory Nuclei of Nerve V (Fig.  6.6) 121
Lateral Zone 121
Midbrain 123
Blood Supply: Basilar Artery and Posterior Cerebral Arteries 123
Brain Stem Level Six: Inferior Colliculus of Midbrain (Fig.  6.7) 123
Tectum 123
Tegmentum 123
Brain Stem Level Seven: Superior Colliculus and Cerebral Peduncle (Fig.  6.8a, b) 125
Tectum 125
Tegmentum 125
Functional Centers in the Brain Stem 127
Reticular Formation 127
Role of Descending Reticular Systems 128
Neurochemically Defined Nuclei in the Reticular Formation Affecting Consciousness 128
Respiration Centers 128
Cardiovascular Centers 129
Deglutition 129
Vomiting 129
Emetic Center 130
Coughing 130
Taste 130
Localization Dysfunction in the Cranial Nerves 131
Localization of Disease Processes in the Brain Stem 132
Guidelines for Localizing Disease in the Brain Stem 132
Neuroanatomical Localization Exercise Chapter 6: Identify the Tracts and Nuclei in the Brain Stem 132
Suggested Readings 134
7: The Cranial Nerves 135
How the Cranial Nerves Got Their Numbers 135
Functional Organization of Cranial Nerves 135
Other Useful Facts on the Cranial Nerves 135
Origins of Cranial Nerves and Associated Muscles 138
The Individual Cranial Nerves 138
Cranial Nerve I, Olfactory (Fig.  7.4), Special Sensory/Special Visceral Afferent 138
Cranial Nerve II, Optic (Fig.  7.5), Special Somatic Sensory 138
Cranial Nerve III, Oculomotor (Fig.  7.6), Pure Motor (Somatic and Parasympathetic) 140
Cranial Nerve IV Trochlear (Fig.  7.6), Pure Motor 140
Cranial Nerve VI, Abducens (Fig.  7.6), Pure Motor 141
Cranial Nerve V, Trigeminal (Fig.  7.7), Mixed Nerve (Sensory and Motor But No Parasympathetic) 141
Clinical Disorders 142
Localization of Sensory Dysfunction of the Trigeminal Nerve 142
Other Causes of Trigeminal Symptoms 142
Cranial Nerve, VII Facial (Fig.  7.8), Mixed Nerve (Sensory, Motor, Parasympathetic) 142
Motor 142
Sensory 143
Cranial Nerve VIII, Vestibulo-Cochlear (Fig.  7.9) 144
Vestibular Nuclei 144
Auditory Pathway 144
Etiology: Multiple Labyrinthine Disease Is the Most Common 148
Cranial Nerve IX, Glossopharyngeal (Fig.  7.13), Mixed (Sensory, Motor, Parasympathetic): Nerve to Third Pharyngeal Arch 148
Cranial Nerve X Vagus (Fig.  7.14) 149
Cranial Nerve XI Spinal Accessory (Fig.  7.15), Pure Motor-Somatic and Visceral 150
Cranial Nerve XII Hypoglossal (Fig.  7.16) 150
Cranial Nerve Dysfunction 151
Motor Cranial Nerve Lesion 151
Cranial Nerve Dysfunction 151
Motor Cranial Nerve Lesions 151
Sensory Cranial Nerve Lesion 152
Cranial Nerve Case Histories 152
Cranial Nerve Case 7.1 152
Cranial Nerve Case 7.2 153
Cranial Nerve Case 7.3 153
Cranial Nerve Case 7.4 153
Suggested Readings 154
8: Diencephalon with Atlas of the Thalamus 155
Overview 155
The Thalamus Has Several Major Roles 155
Thalamus from a Phylogenetic Perspective 155
Functional Divisions of Thalamic Nuclei 155
Nuclei of the Thalamus 156
Functional Organization of Thalamic Nuclei (Table  8.1) 156
Sensory and Motor Relay Nuclei: The Ventrobasal Complex and Lateral Nucleus 156
Limbic Nuclei: The Anterior, Medial, Lateral Dorsal, Midline, and Intralaminar Nuclei (Fig.  8.5) 159
Specific Associational-Polymodal/Somatic Nuclei-The Pulvinar Nuclei (Fig.  8.5) 159
Special Somatic Sensory Nuclei-Vision And Audition, The Lateral Geniculate And Medial Geniculate Nuclei of the Metathalamus (Fig.  8.4) 160
Nonspecific Associational 161
White Matter of the Diencephalon 161
Relationship Between the Thalamus and the Cerebral Cortex (Figs.  8.7 and 8.8) 163
Clinical Considerations 164
Subthalamus (Fig.  8.3) 164
Thalamic Atlas (Figs.  8.9 – 8.11) 164
Level: Midbrain – Diencephalic Junction (Fig.  8.9) 165
Level: Midthalamus (Fig.  8.10) 166
Level: Anterior Tubercle of Thalamus (Fig.  8.11) 169
Selected Readings 169
9: Hypothalamus 171
Hypothalamus 171
Hypothalamic Nuclei 171
Afferent Pathways (Fig.  9.7) 172
Efferent Pathways (Fig.  9.8) 173
Functional Stability (Fig.  9.11) 175
Neuroendocrine System, the Hypothalamus and Its Relation to the Hypophysis 176
Hypophysis Cerebri 176
Hypothalamic-Hypophyseal Portal System 176
Case History 9.1 (Fig.  9.11) 177
Hypophysiotrophic Area 177
Hormones Produced by Hypothalamus 178
Hormones Produced in Adenohypophysis 178
Hormones Produced in the Adenohypophysis (Fig.  9.13) 178
Hypothalamus and the Autonomic Nervous System 179
Functional Localization in Hypothalamus 179
Autonomic Nervous System (Figs.  9.14 and 9.15) 181
The Autonomic Nervous System 183
Enteric Nervous System (Fig.  9.15) 183
Parasympathetic System (Cranio-Sacral) (Figs.  9.14 and 9.15) 184
Cranial Nerves – III, VII, IX, X 184
Sacral Segments S2–4 184
Sympathetic System (Figs.  9.14 and 9.15) 184
Cervical Sympathetic Ganglia 185
Thoracic Sympathetic Ganglia 185
Lumbar Sympathetic Ganglia 185
Autonomic Dual Innervation of Specific Structures (Fig.  9.14) 185
Eye 185
Lacrimal Glands 185
Salivary Glands 185
Heart 186
Lungs 186
Abdominal Viscera 186
Pelvis 186
Cutaneous and Deep Vessels, Glands, and Hair 186
Disorders of the Autonomic Nervous System 186
Bladder 186
References 187
Suggested Readings 187
10: Cerebral Cortex Functional Localization 189
Anatomical Considerations 189
Cerebral Cortical Gray Matter 189
Cytology 190
Basic Design and Functional Organization of Cerebral Cortex 191
Fundamental Types of Cerebral Cortex 192
The Schema of the Fundamental Six Layered Neocortex (refer to Fig.  10.5) 192
Classification of the Neocortex (Fig.  10.6) 193
How the Brodmann Areas Got Their Numbers 193
Correlation of Neocortical Cytoarchitecture and Function 194
Lobes in the Human Cerebrum (Figs.  10.8 and 10.9) 194
Frontal Lobe (Figs.  10.8 and 10.9) 195
Motor Areas 195
Prefrontal – Nonmotor areas 198
Parietal Lobe (Figs.  10.8 and 10.9) 198
Temporal Lobe (Figs.  10.6 and 10.7) 198
Occipital Lobe (Figs.  10.7 and 10.8) 199
Subcortical White Matter Afferents and Efferents 200
Afferent Inputs and Efferent Projections of Neocortex 201
Nonthalamic Sources of Cortical Input 202
Methods for the Study of Functional Localization in Cerebral Cortex 202
How Do We Study Function? 202
Stimulation 202
Evoked Potentials (Fig.  10.14) 202
How Do We Confirm the Location of the Pathology? 204
Neurophysiology Correlates of Cortical Cytoarchitecture and the Basis of the Electroencephalogram 204
References 205
Suggested Readings 205
Part2: The Systems 207
11: Motor System I: Movement & Motor Pathways
Cerebral Cortical Motor Functions 208
Reflex Activity 208
Concept of Central Pattern Generators 208
Postnatal Development of Motor Reflexes 211
Relationship of Primary Motor, Premotor and Prefrontal Cortex 211
Functional Overview 211
Primary Motor Cortex Area 4 (Figs.  11.3 and 11.5) 212
Case 11.1 213
Areas 6, Premotor Cortex (Areas 6 and 8 Fig.  11.5)214
Case 11.2 215
Area 8-Premotor 216
Suppressor Areas for Motor Activity (Negative Motor Response) 217
Prefrontal Cortex (Areas 9, 10, 11, 12, 13, 14, and 46 Fig 10.5)217
Overview of the Role of the Prefrontal Area in Motor and Cognitive Function 217
Disorders of Motor Development 218
Studies of Recovery of Motor Function in the Human 218
Cortical Control of Eye Movements 219
Frontal (Area 8) And Parieto-Occipital Eye Fields 219
Major Voluntary Motor Pathways 220
Basic Principals of Voluntary Motor System 220
Corticospinal Tracts: Voluntary Control of the Limbs, Thorax and Abdomen (Fig.  11.8) 220
Corticonuclear/Corticobulbar System: Voluntary Control of the Muscles Controlled by Cranial nerves V, VII, and IX to XII (Fig.  11.9) 220
Corticomesencephalic System: Voluntary Control of Muscles Associated with Eye Movements- Cranial Nerves III, IV, and VI (see also discussion above in Chap. 9- Cranial nerve VI. Cortical Control of Eye Movements) 221
Rubrospinal and Tectospinal Tracts 222
References 222
Suggested Readings 223
Hydrocephalus 223
Elderly Gait Disorders 224
Control of Movement 224
The Pyramidal Tract and Other Descending Motor Systems 225
The Central Control of Eye Movement by Cerebral Cortex 225
Postnatal Development and Disorders of Development 225
12: Motor System II: Basal Ganglia 226
Overview of the Dopaminergic Systems 229
Clinical Symptoms and Signs of Dysfunction 229
Specific Syndromes Parkinson’s Disease and the Parkinsonian Syndrome (Recent reviews are provided by Olanow and Tatton 1999) 230
Case 12.1 233
Differential Diagnosis of Parkinson’s Disease 234
Chorea, Hemichorea, and Hemiballismus 235
Hemichorea and Hemiballism 236
Case 12.2 236
Case 12.3 237
Generalized Chorea 237
Case 12.4 239
Other Movement Disorders Associated with Diseases of the Basal Ganglia 239
References 240
Suggested Headings 241
13: Motor System III: Cerebellum 244
Subdivisions of the Cerebellum 244
Longitudinal Divisions 244
Transverse Divisions 244
Cytoarchitecture of the Cerebellum 244
Topographic Patterns of Representation in Cerebellar Cortex 247
Functions of the Cerebellum and Correlations 247
Effects of Disease on the Cerebellum 247
Major Cerebellar Syndromes 248
Syndrome of the Floccular Nodular Lobe and Other Midline Cerebellar Tumors 249
Case 13.1 250
Case 13.2 (Fig.  13.6) 250
Syndrome of the Anterior Lobe 251
Case 13.4 252
Other Causes of Cerebellar Atrophy 252
Syndrome of the Lateral Cerebellar Hemispheres (Neocerebellar or Middle-Posterior Lobe Syndrome) 253
Syndromes of the Cerebellar Peduncles 254
Vascular Syndromes of the Cerebellum- Vertebral Basilar 254
Syndromes of Occlusion and Infarction 254
Case 13.6 (Fig.  13.10) 254
Causes of Hemorrhage into the Cerebellum 255
Spinocerebellar Degenerations 255
The Autosomal Recessive Cerebellar Ataxias (ADCA) Are Usually of Early Onset (< 20 Years of Age)
Autosomal Dominant Disorders: The Autosomal Dominant Cerebellar Ataxias (ADCA) Are Usually of Late Onset (> 20 years): Azorean Disease: Machado-Joseph Disease
An Overview of Tremors 256
References 257
Cited References 257
Bibliography: Cerebellum and Movement General, Anatomy, Physiology and Functional Localization 257
Vascular Syndromes of the Cerebellum 258
Degenerations and Systemic Disorders (See also Chapters 19 and 27) 258
Tremor 259
14: Somatosensory Functions and the Parietal Lobe 260
Postcentral Gyrus: Somatic Sensory Cortex (Primary Sensory S-I) 260
Organization of the Postcentral Gyrus 260
Postcentral Gyrus Stimulation 260
Postcentral Gyrus Lesions 261
Case 14.1 (Fig.  14.2) 262
Case 14.2 263
Superior and Inferior Parietal Lobules 264
Dominant Hemisphere in the Parietal Lobules 264
Nondominant Hemisphere in the Parietal Lobules 265
Case 14.3 265
Parietal Lobe and Tactile Sensation from the Body 267
Tactile Sensation from the Body: Medial Lemniscus (Fig.  14.5) 267
Posterior Columns: Tactile Sensation from the Neck, Trunk, and Extremities (Fasciculus Gracilis and Cuneatus) 267
Tactile Sensation from the Head (Fig.  14.6) 268
References 269
Suggested Readings 270
Amygdala, Emotion, Autism and Psychiatric Disorders 271
Olfactory References 272
15: Visual Systems 273
Structure of the Eye 273
Photoreceptor Layer: Rods and Cones 276
Cones: Color Vision 277
Optic Nerve 278
Blind Spot 278
Visual Pathway (Fig.  15.4) 278
Retina and Visual Fields 278
Visual Pathway: Overview (Fig.  15.4) 279
Optic Nerve Termination in the LGN 280
Light Reflexes 280
Occipital Lobe 280
Occipital Lobe 280
Areas in Occipital Lobe-17–19 (V1–5) 280
Parallel Processing in the Visual Cortex 280
Striate Cortex Area 17 (V1) 281
Extrastriate Visual Cortex Areas 18 and 19 281
Intracortical Associations Between Striate and Nonstriate Cortex 281
Callosal Fibers 281
Termination of Optic Radiation 281
Ocular Dominance Columns 281
Retinal Representation in the Occipital Cortex 281
Responses of Neurons in Striate Cortex (Fig.  15.6) 281
Perceptual Pathways: Color Vision 282
Summary 283
Effects of Stimulation of Areas 17–19 283
Effects of Lesion in the Occipital Visual Areas 284
Complete Unilateral Ablation of Area 17 (V1) 284
Partial Lesions in Area 17 284
Vascular Lesions 284
Lesions of Extrastriate Areas 18 and 19 284
Unilateral Lesions Limited to Areas 18 and 19 284
Bilateral Lesions Limited to Areas 18 and 19 284
Occipital Lobe and Eye Movements 285
Visual Field Deficits Produced by Lesions in the Optic Pathway 285
Case Histories with Lesions in the Visual System: Optic Nerve – Optic Chiasm – Optic Radiation – Striate Cortex 286
Case History 15.1 (Fig.  15.6) 286
Case 15.2 286
Case 15.3 288
Case History 15.4 (Fig.  15.12) 288
Case History 15.5 288
References 290
16: Limbic System and the Temporal Lobe 293
Introduction 293
Olfactory System 293
Limbic System 294
Subcortical Structures 295
Cortical Structures in the Limbic System 297
Temporal Lobe: Amygdala, Hippocampal Formation, Parahippocampal Cortex 297
Hippocampal Sectors 300
Cytoarchitecture of the Hippocampus 300
Dentate Gyrus: Cytoarchitecture of the Dentate Gyrus 301
Other Cortical Regions of the Limbic System 304
Principal Pathways of the Limbic System 305
Fornix (Fig.  16.2) 305
Origin of Fornix 305
Different Portions of the Fornix Have Specific Names 305
Circuits in Emotional Brain 305
Role of the Temporal Lobe in Learning and Memory 306
Area 41, The Primary Auditory Cortex 306
Visual Perceptions 307
Symptoms of Disease Involving the Temporal Lobe 307
Symptoms Following Stimulation of the Temporal Lobe 307
Symptoms from Ablation of or Damage to the Temporal Lobe 307
Case 16.1: Seizures from Left Temporal Lobe 308
Case 16.2 309
Case 16.3 309
Hippocampal System and Memory 309
Localization of Regions in the Brain That Subserve Memory 311
Case 16.3 (Patient of Doctor John Sullivan and Doctor John Hills) 312
Progressive Dementing Process in the Cerebrum – Alzheimer’s Disease 312
Case 16.4: Alzheimer’s Disease 313
The Role of the Prefrontal Granular Areas and Emotions 314
Functional Neurosurgery 315
Case History 16.5: Prefrontal Disease 316
The Limbic Brain as a Functional System 317
References 318
17: Higher Cortical Functions 323
Cerebral Cortex and Disturbances of Verbal Expression 323
Cerebral Dominance 323
Development Aspects 324
Aphasia: Dominant Hemispheric Functions 324
Nonfluent Aphasias 327
Anatomical Correlation of Specific Syndromes Involving Broca’s Area 327
Case 17.1 328
Case 17.2 329
Case 17.3 329
The Fluent Aphasias 330
Case 17.4 330
Case 17.5 331
Case 17.6 332
Case 17.7 333
Nondominant Parietal Hemisphere Functions 334
Role of Corpus Callosum in Transfer of Information 334
References 335
Suggested Reading 336
Part3: The Non-Nervous Elements 340
18: Meninges, Ventricular System and Vascular System 341
Meninges Coverings of the Brain (Fig.  18.1) 341
Dura Mater 341
Arachnoid (Fig.  18.1) 341
Pia Mater (Figs.  18.1 and 18.2) 341
Ventricular System (Fig.  18.3) 343
Blood Supply to the Brain 344
Arterial Supply to the Brain (Figs.  18.4 and 18.5) 344
Anterior Circulation 344
Posterior Circulation (Figs.  18.8 and 18.9) 345
Venous Circulation of the Brain 347
19: Vascular Diseases 349
Overview 349
Occlusive Cerebrovascular Disease 349
Definitions 349
Role of Anastomoses 350
Types of Ischemic Occlusive Disease 350
Clinical Correlates of Vascular Territories-Syndromes 350
Internal Carotid Artery (ICA) 350
Case History 19.1: Carotid Occlusion with Retinal and Hemispheric TIAs 351
Middle Cerebral Artery Syndromes: The MCA Is the Major Terminal Branch of the Internal Carotid Artery (ICA) 351
Case History 19.2: Total Middle Cerebral Artery Occlusion 352
Anterior Cerebral Artery Syndrome (The ACA Is the Smaller Terminal Branch of the ICA) (Fig.  19.4) 353
Posterior Cerebral Artery Syndromes 353
Vertebral and Basilar Artery Syndromes of the Brain Stem 354
Case History 19.3: Lateral Medullary Syndrome 356
Intracerebral Hemorrhage 357
Subarachnoid Hemorrhage 358
Case History 19.4: Subarachnoid Hemorrhage Secondary to an Aneurysm of the Posterior Communicating Artery 359
References 359
20: General Case Histories from the CNS-Problem Solving 360
Case History 20.1 360
Neurological Examination 360
Questions 360
Clinical Diagnosis 360
Laboratory Data 360
Comment 360
Case History 20.2 (Patient of Dr. John Sullivan) 361
Neurological Examination 361
Questions 361
Clinical Diagnosis 361
Laboratory Data 361
Comment 361
Case History 20.3 362
Neurological Examination 362
Questions 362
Clinical Diagnoses 362
Laboratory Data 362
Comment 363
Case History 20.4 363
Past History 363
Neurological Examination 363
Questions 364
Clinical Diagnosis (Relevant Acute Diagnosis) 364
Laboratory Data 364
Comment 364
Case History 20.5 (Modified from Marcus and Jacobson 2003 , 2010) 364
Neurological Examination 364
Questions 365
Clinical Diagnosis 365
Laboratory Data 365
Comment 365
Case History 20.6 366
Past History 366
Neurological Examination 366
Subsequent Course 366
Questions 366
Clinical Diagnosis 366
Comment 366
Case History 20.7 367
Past History 367
Neurological Examination 367
Hospital Course 367
Questions 368
Clinical Diagnosis 368
Comment 368
Case History 20.8 368
Past History 368
General Examination 368
Neurological Examination 368
Questions 369
Clinical Diagnosis 369
Comment 369
Case History 20.9 369
Neurological Examination 369
Subsequent Course 369
Questions 369
Clinical Diagnosis 369
Comment 370
Case History 20.10 370
Neurological Examination 370
Laboratory Data 370
Questions 370
Clinical Diagnosis 370
Comment 370
Case History 20.11 371
Past History 371
General Physical Examination 371
Neurological Examination 371
Questions 372
Clinical Diagnosis 372
Comment 372
Case History 20.12 372
Past History 373
General Physical Examination 373
Neurological Examination 373
Laboratory Data 373
Question 373
Subsequent Course 373
Question 373
Subsequent Course 373
Question 373
Neurological Examination 374
Question 374
Subsequent Course 374
Questions 374
Clinical Diagnosis 374
Comment 374
Case History 20.13 (Modified from Marcus and Jacobson 2003 , 2010) 374
Past Medical History 375
Family History 375
Neurological Examination 375
Questions 375
Clinical Diagnosis 375
Laboratory Data 375
Subsequent Course 375
Comment 376
Case History 20.14 376
Neurological Examination 376
Questions 377
Clinical Diagnosis 377
Laboratory Data 377
Comment 377
Reference 377
21: Movies On The Brain 378
Neuroanatomists, Anatomists, Neurosurgeons and Neurologists 378
The Neuroanatomy Lesson: Film: Young Frankenstein 378
The Provision of Cadavers for Dissection. Film: The Body Snatcher 378
The Activities of the Neurosurgeon. Film: The Man with Two Brains 378
The Creativity of the Neurologist. Film: Freud 378
The Neurological Examination. Film: The Fortune Cookie 379
Developmental Disorders 379
Neurological Disorder: Reduced Intellectual Capacities. Film: Charley 379
*Neurological Disorder: A Blind Deaf and Mute Infant After Fever. Film: The Miracle Worker 379
*Neurological Disorder: Autism. Movie: Rain Man 379
Neurological Disorder: Limited Intellectual Function Associated with Limited Capacity for Emotional Expression and for Recognition of Emotional Expression: Possible Asperger’s Syndrome. Film: Being There 379
Neurological Disorder: Developmental Disorder Affecting Intellectual and Motor Function. Film: Forrest Gump 379
Spinal Cord/Brain Stem Disorders 379
*Neurological Disorder: Traumatic High Cervical Spinal Cord Transection Producing Quadriplegia: Ethical Issues: The Rights of the Patient to Make Decisions About How Long to Continue Life Support. Film: Million Dollar Baby 379
Neurological Disorder: Traumatic High Cervical Spinal Cord Compression Producing Quadriplegia: The Bone Collector 380
Neurological Disorder: Traumatic Cervical Cord Transaction Producing Quadriplegia. Film: Whose Life is it Anyway 380
Neurological Disorder: Thoracic Spinal Cord Injury. Film: Passion Fish 380
Neurological Disorder: Poliomyelitis (FDR Subsequently Died of a Hypertensive Intracerebral Hemorrhage). Film: Sunrise At Campobello 380
*Neurological Disorder: Amyotrophic Lateral Sclerosis. Film: Pride of the Yankees 380
Neurological Disorder: Amyotrophic Lateral Sclerosis. Film: Tuesdays with Morrie 380
Neurological Disorder: Locked in Syndrome Due to Basilar Artery Thrombosis. Film: The Diving Bell and the Butterfly 380
Disorders of Motor Systems and Motor Control 381
*Neurological Disorder: Cerebral Palsy: Spastic Diplegia and Choreo-Athetosis. Film: My Left Foot 381
*Neurological Disorder: Parkinson’s Disease. Film: Awakenings 381
*Neurological Disorder: Obsessive-Compulsive Disorder, Psychosis and Post-Traumatic Disorder with Complex Partial Seizures: Film: The Aviator 381
Neurological Disorder: Obsessive-Compulsive Disorder Plus Personality Disorder. Film: As Good As It Gets 381
Neurological Disorder: Huntington’s Disease. Films: Bound For Glory and Alice’s Restaurant 381
Cerebral Cortex 381
*Neurological Disorder: Foreign Arm/Hand Syndrome. Film: Dr Strangelove Or: How I Learned To Stop Worrying and Love The Bomb 382
Problems in Reading. Film: The Reader 382
A Possible Acute Syndrome of the Corpus Callosum. Film: All of Me 382
Limbic System 382
*Neurological Disorder: Prefrontal Lobotomy/Psychosurgery. Film: Suddenly Last Summer 382
*Neurological Disorder: The Effects Of Neuroleptics, Electroshock Therapy and The Complications Of Prefrontal Lobotomy. Film: One Flew Over The Cuckoo’s Nest 382
Cerebrovascular Disease 383
Neurological Disorder: Massive Stroke. Film: Wilson 383
Neurological Disorder: Massive Stroke Producing Irreversible Coma. Film: Dave 383
Brain Trauma 383
*Neurological Disorder: Traumatic Frontal Lobe Injury. Film: Regarding Henry 383
*Neurological Disorder: Post-Traumatic Short Term Memory Loss due to Right Temporal Lobe (Hippocampal) Damage Which Spares Her Amygdala. Film: 50 First Dates (A.K.A 50 First Kisses) 383
Neurological Disorder: Brain Trauma Producing Coma. Film Fantastic Voyage 383
Neurological Disorder: Post-Traumatic Acrophobia Triggering Vertigo. Film: Vertigo 384
Brain Tumors and Increased Intracranial Pressure 384
*Neurological Disorder: Brain Tumor. Film: Dark Victory 384
Neurological Disorder: Glioma in an Adolescent. Film: Death Be Not Proud 384
Infections 384
*Neurological Disorder: Severe Neurological Disability and Death Following Partially Treated Bacterial Meningitis. Film: The Third Man 384
*Neurological Disorder: Neurosyphilis (General Paresis) Producing Dementia and a Change in Personality. Film: Young Winston 385
Neurological Disorder: Syphilis. Film: Dr Ehrlich’s Magic Bullet 385
The Story of Louis Pasteur 385
Old Yeller 385
Toxic and Metabolic Disorders 385
*Neurological Disorder: Metabolic Induced Psychosis. Film: The Hospital 385
Neurological Disorder: Drug Addiction: Barbituates Plus. Film: Dead Ringers 385
*Neurological Disorder: Cocaine Addiction. Film: The Seven-Percent Solution 386
Neurological Disorder: Acute Arsenic Poisoning and Criminal Psychosis. Film: Arsenic and Old Lace 386
Neurological Disorder: A Metabolic Disorder (Porphyria). Film: The Madness of King George 386
Neurological Disorder: Mercury Poisoning. Film: Alice in Wonderland 386
Neurological Disorder: Effects of Hallucinogens and Sleep Deprivation. Film: Altered States 386
*Neurological Disorder: Severe Alcoholism with Alcoholic Withdrawal Syndrome. Film: The Lost Weekend 386
Neurological Disorder: Alcoholism and Acute Withdrawal. Film: Days of Wine and Roses 387
Disorders of Myelin 387
*Neurological Disorder: Progressive Multiple Sclerosis. Film: Jackie and Hilary 387
Neurological Disorder: Adrenoleukodystrophy: A Disorder that Affects Brain, Spinal Cord and Peripheral Nerves as well as the Adrenal Gland. There is Defective Formation of Myelin. Film: Lorenzo’s Oil 387
Seizures and Epilepsy 387
Neurological Disorder: Temporal Lobe Seizures with Secondary Generalization. Film: The Terminal Man 387
Neurological Disorder: Post-Traumatic Focal Motor Seizures with Secondary Generalization. Film: Cleopatra 387
*Neurological Disorder: Generalized Convulsions and Learning Disabilities. Film: The Lost Prince 387
*Neurological Disorder: Seizures Induced by Photic Stimulation and Sleep Deprivation. Film: The Andromeda Strain 387
Other Films in this Category 388
Coma 388
*Neurological Disorder: Anoxic Encephalopathy. Film: Coma 388
*Neurological Disorder: Irreversible Coma Following Insulin Overdose. Film: Reversal of Fortune 388
*Neurological Disorder: Anesthetic Accident Producing Anoxic Encephalopathy With Irreversible Coma. Film: The Verdict 388
Memory 388
* Neurological Disorder: Alzheimer’s Disease. Film : Iris 388
Neurological Disorder: Dementia Beginning with Problems in Driving. Film: Driving Miss Daisy 388
Neurological Disorder: Short Term Memory Loss. Film: Memento 389
Other Films in this Category Dementia 389
Part4: ATLAS 390
22: Descriptive Atlas of the Cerebrum in Gross Sections and Stained Sections 391
Coronal and Horizontal Sections of Gross Brain Labeled 391
Myelin-Stained Labeled Sections of the Brain 391
Coronal Sections 391
Horizontal Sections 391
Sagittal Sections 391