- •Preface
- •Contents
- •1 Elements of the Nervous System
- •2 Somatosensory System
- •3 Motor System
- •4 Brainstem
- •5 Cerebellum
- •6 Diencephalon and Autonomic Nervous System
- •7 Limbic System
- •8 Basal Ganglia
- •9 Cerebrum
- •10 Coverings of the Brain and Spinal Cord; Cerebrospinal Fluid and Ventricular System
- •Further Reading
- •Index
- •Abbreviations
- •1 Elements of the Nervous System
- •Elements of the Nervous System
- •Information Flow in the Nervous System
- •Synapses
- •Neurotransmitters and Receptors
- •Functional Groups of Neurons
- •Glial Cells
- •Development of the Nervous System
- •2 Somatosensory System
- •Peripheral Nerve, Dorsal Root Ganglion, Posterior Root
- •Peripheral Regulatory Circuits
- •Central Components of the Somatosensory System
- •Posterior and Anterior Spinocerebellar Tracts
- •Posterior Columns
- •Anterior Spinothalamic Tract
- •Lateral Spinothalamic Tract
- •Other Afferent Tracts of the Spinal Cord
- •Central Processing of Somatosensory Information
- •Somatosensory Deficits due to Lesions at Specific Sites along the Somatosensory Pathways
- •3 Motor System
- •Central Components of the Motor System and Clinical Syndromes of Lesions Affecting Them
- •Motor Cortical Areas
- •Corticospinal Tract (Pyramidal Tract)
- •Corticonuclear (Corticobulbar) Tract
- •Other Central Components of the Motor System
- •Lesions of Central Motor Pathways
- •Peripheral Components of the Motor System and Clinical Syndromes of Lesions Affecting Them
- •Clinical Syndromes of Motor Unit Lesions
- •Complex Clinical Syndromes due to Lesions of Specific Components of the Nervous System
- •Spinal Cord Syndromes
- •Vascular Spinal Cord Syndromes
- •Nerve Root Syndromes (Radicular Syndromes)
- •Plexus Syndromes
- •Peripheral Nerve Syndromes
- •Syndromes of the Neuromuscular Junction and Muscle
- •4 Brainstem
- •Surface Anatomy of the Brainstem
- •Medulla
- •Pons
- •Midbrain
- •Olfactory System (CN I)
- •Visual System (CN II)
- •Eye Movements (CN III, IV, and VI)
- •Trigeminal Nerve (CN V)
- •Facial Nerve (CN VII) and Nervus Intermedius
- •Vagal System (CN IX, X, and the Cranial Portion of XI)
- •Hypoglossal Nerve (CN XII)
- •Topographical Anatomy of the Brainstem
- •Internal Structure of the Brainstem
- •5 Cerebellum
- •Surface Anatomy
- •Internal Structure
- •Cerebellar Cortex
- •Cerebellar Nuclei
- •Connections of the Cerebellum with Other Parts of the Nervous System
- •Cerebellar Function and Cerebellar Syndromes
- •Vestibulocerebellum
- •Spinocerebellum
- •Cerebrocerebellum
- •Cerebellar Tumors
- •6 Diencephalon and Autonomic Nervous System
- •Location and Components of the Diencephalon
- •Functions of the Thalamus
- •Syndromes of Thalamic Lesions
- •Thalamic Vascular Syndromes
- •Epithalamus
- •Subthalamus
- •Hypothalamic Nuclei
- •Afferent and Efferent Projections of the Hypothalamus
- •Functions of the Hypothalamus
- •Sympathetic Nervous System
- •Parasympathetic Nervous System
- •Visceral and Referred Pain
- •7 Limbic System
- •Anatomical Overview
- •Internal and External Connections
- •Microanatomy of the Hippocampal Formation
- •Amygdala
- •Functions of the Limbic System
- •Types of Memory
- •8 Basal Ganglia
- •Preliminary Remarks on Terminology
- •The Role of the Basal Ganglia in the Motor System: Phylogenetic Aspects
- •Connections of the Basal Ganglia
- •Function and Dysfunction of the Basal Ganglia
- •Clinical Syndromes of Basal Ganglia Lesions
- •9 Cerebrum
- •Development
- •Gross Anatomy and Subdivision of the Cerebrum
- •Gyri and Sulci
- •Histological Organization of the Cerebral Cortex
- •Laminar Architecture
- •Cerebral White Matter
- •Projection Fibers
- •Association Fibers
- •Commissural Fibers
- •Functional Localization in the Cerebral Cortex
- •Primary Cortical Fields
- •Association Areas
- •Frontal Lobe
- •Coverings of the Brain and Spinal Cord
- •Dura Mater
- •Arachnoid
- •Pia Mater
- •Cerebrospinal Fluid Circulation and Resorption
- •Arteries of the Anterior and Middle Cranial Fossae
- •Arteries of the Posterior Fossa
- •Collateral Circulation in the Brain
- •Dural Sinuses
- •Venous Drainage
- •Cerebral Ischemia
- •Arterial Hypoperfusion
- •Particular Cerebrovascular Syndromes
- •Impaired Venous Drainage from the Brain
- •Intracranial Hemorrhage
- •Intracerebral Hemorrhage (Nontraumatic)
- •Subarachnoid Hemorrhage
- •Subdural and Epidural Hematoma
- •Impaired Venous Drainage
- •Spinal Cord Hemorrhage and Hematoma
- •Further Reading
- •Index
I
Baehr, Duus' Topical Diagnosis in Neurology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.
III
Duus’
Topical Diagnosis
in Neurology
Anatomy · Physiology · Signs · Symptoms
4th completely revised edition
Mathias Baehr, M.D.
Professor of Neurology and Chairman
Department of Neurology
University of Goettingen
Goettingen, Germany
Michael Frotscher, M.D.
Professor of Anatomy and Chairman
Department of Anatomy and Cell Biology
University of Freiburg
Freiburg, Germany
With contributions by
Wilhelm Kueker
Founding author Peter Duus
Translated by Ethan Taub, M.D.
400 illustrations, most in color,
by Professor Gerhard Spitzer and Barbara Gay
Thieme
Stuttgart · New York
Baehr, Duus' Topical Diagnosis in Neurology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.
IV
Library of Congress Cataloging-in-Publication Data
Baehr, Mathias.
[Duus’ neurologisch-topische Diagnostik. English] Duus’ topical diagnosis in neurology : anatomy, physiology, signs, symptoms/Mathias Baehr, Michael Frotscher ; with contributions by Wilhelm Kueker ; translated by Ethan Taub ; illustrated by Gerhard Spitzer. 4th, rev. ed.
p. ; cm.
Rev. translation of the 8th German ed. c2003. Includes index.
ISBN 313-6128044 (GTV : alk. paper) ISBN 158890-2153 (TNY : alk. paper)
1.Nervous systemDiseasesDiagnosis.
2.Neuroanatomy. 3. Anatomy, Pathological.
4. Nervous systemPathophysiology. I. Frotscher, M. (Michael), 1947- . II. Duus, Peter, 1908-. Topical diagnosis in neurology. III. Title. IV. Title: Topical diagnosis in neurology. [DNLM: 1. Nervous System Diseasesdiagnosis. 2. Nervous Systemanatomy & histology.
3. Nervous Systemphysiopathology. WL 141 B139d 2005a] RC347.D8813 2005
616.8’04754dc22 2005013120
1st Brazilian
(Portuguese) edition 1985 1st Indonesian 2nd Brazilian
(Portuguese) edition 1990 edition 1996
1st Chinese edition 1996
1st English edition 1983 2nd English edition 1989 3rd English edition 1998
1st French edition 1998
1st German edition 1976 2nd German edition 1980 3rd German edition 1983 4th German edition 1987 5th German edition 1990 6th German edition 1995 7th German edition 2001 8th German edition 2003
1st Italian edition 1987
1st Japanese edition 1982 2nd Japanese edition 1984 3rd Japanese edition 1988 4th Japanese edition 1999
1st Korean edition 1990
1st Polish edition 1990
1st Russian edition 1996
1st Spanish edition 1985
1st Turkish edition 2001
© 2005 Georg Thieme Verlag, Rüdigerstrasse 14, 70469 Stuttgart, Germany
http://www.thieme.de
Thieme New York, 333 Seventh Avenue, New York, NY 10001 USA http://www.thieme.com
Cover design: Cyclus, Stuttgart
Typesetting by primustype Hurler, Notzingen Printed in Germany by Appl, Wemding
ISBN 313-6128044 (GTV) |
|
ISBN 158890-2153 (TNY) |
1 2 3 4 5 |
Important note: Medicine is an ever-changing science undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book.
Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers’ leaflets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user’s own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed.
This book is an authorized and revised translation of the 8th German edition published and copyrighted 2003 by Georg Thieme Verlag, Stuttgart, Germany. Title of the German edition: Duus’ Neurologischtopische Diagnostik
Contributor: Wilhem Küker, M.D., Radiological
Clinic, Department of Neuroradiology, University
Hospital Tübingen, Germany
Translator: Ethan Taub, M.D., Klinik im Park, Zurich, Switzerland
Illustrators: Gerhard Spitzer, Frankfurt/M;
Barbara Gay, Stuttgart
Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain.
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, preparation of microfilms, and electronic data processing and storage.
Baehr, Duus' Topical Diagnosis in Neurology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.
V
Preface
This is the first complete revision of Duus’ textbook of topical diagnosis in neurology since the death of its original author, Professor Peter Duus, in 1994. As is well known, the intervening time has witnessed major developments, both in the clinical neurosciences and in basic research. In particular, modern imaging techniques such as magnetic resonance imaging and positron emission tomography on the one hand, and the new molecular biological understanding of the development, plasticity, and pathology of the nervous system on the other, have brought about substantial progress in our knowledge in the field of neuroscience. Yet, despite all of the advances in ancillary diagnostic techniques, topical neurological diagnosis—the correct attribution of symptoms or syndromes to lesions at specific sites in the nervous system—remains today the primary task of the clinical neurologist.
In this entirely new, thoroughly revised edition of “Duus,” we have tried to preserve the remarkably effective didactic conception of the book while bringing it up to date. We have replaced older case studies based mainly on history by new ones more closely reflecting current practice, provided multicolored illustrations to ease and enhance comprehension, and added state-of-the-art neuroradiological images to demonstrate the correlation of structure and function in nervous system lesions. We have also newly color-coded the section headings to enable readers to distinguish at a glance between neuroanatomical (blue) and clinical (green) material, without having to disrupt the thematic continuity of the text.
Welcome changes in the undergraduate medical curriculum over the past two decades have vastly increased the exposure of medical students in the socalled “preclinical” years to clinical case material. To make the book more accessible to these students, we have written a new first chapter entitled “Elements of the Nervous System,” and we have also added a brief summary of basic concepts at the beginning of each of the other chapters.
The authors thank Georg Thieme Verlag and Dr. Kundmueller for their diligence and for many constructive discussions, as well as Mrs. Gay for her outstanding work on the illustrations.
We hope that this “new Duus,” like the earlier editions, will merit the appreciation of its audience, and we look forward to receiving readers’ comments in any form that they choose.
Professor M. Baehr Professor M. Frotscher Associate Professor W. Küker
Baehr, Duus' Topical Diagnosis in Neurology © 2005 Thieme
All rights reserved. Usage subject to terms and conditions of license.