The brain, more complex than any computer that has ever been invented, is a unique and special organ: It is what makes us human. The science of the brainÐ²Ð”neuroscienceÐ²Ð”has emerged as one of the most exciting fields of research and now occupies a central role as a substrate for clinical medicine. At the heart of neuroscience lies the structure of the nervous system: neuroanatomy. An understanding of the nervous system and its anatomy is essential not just to researchers and not just to neurologists and psychiatrists but to clinicians in all subspecialties, because they all will encounter patients with disorders involving the brain, spinal cord, and peripheral nerves. Stroke, for example, is the third most frequent cause of death in industrialized societies; mood disorders such as depression affect more than one person in 10; and dysfunction of the nervous system can be seen in 25% of patients in most general hospitals at some time during their hospital stay. The neuroanatomic basis for many of these disorders is already known, and for other disorders it will soon be discovered.
This book provides a concise but comprehensive and easy-to-remember synopsis of neuroanatomy and of its functional and clinical implications. In this new, 25th edition, each chapter has been extensively revised and carefully focused so that it emphasizes the most important concepts, facts, and structures. As a teacher, researcher, and clinician, I have tried to sculpt this book so that it will provide a resource and learning tool for busy medical students, residents, and students in health-related fields such as physical therapy; for graduate students who need an introduction to neuroanatomy; and for clinicians in practice, for whom minutes are precious. This book is not meant to supplant the longer, more encompassing, and comprehensive handbooks of neuroscience and neuroanatomy. On the contrary, it provides a more manageable and concise overview that presents the essential aspects of neuroanatomy and its functional and clinical correlations.
This book is unique in including a section entitled "Introduction to Clinical Thinking," which appears early in the text to introduce the reader to the logical processes involved in using neuroanatomy as a basis for thinking about the disordered nervous system. Recognizing that some students remember patients better than isolated facts, I have included discussions of clinical correlates and clinical illustrations that synthesize the most important characteristics of patients selected from an extensive clinical experience to help the reader interpret and remember neuroanatomic concepts in terms of function and clinical implications.
Because much of neuroanatomy has a spatial aspect, this book includes numerous figures. The illustrations have been designed to provide clear, explicit, and memorable representations of important pathways, structures, and mechanisms. Many tables are included, and they have been designed to be as clear and easy to remember as possible. These figures and tables incorporate feedback and suggestions from numerous trainees as well as teachers of neuroanatomy.
The advent of modern neuroimaging has revolutionized the clinical neurosciences, and this book takes full advantage of this technological advance by including numerous computed tomography (CT) and magnetic resonance images (MRIs) of the normal brain and spinal cord, together with functional magnetic resonance images (fMRI) which provides a noninvasive window on brain function. Also included are neuroimaging studies that illustrate common pathological entities that affect the nervous system, including stroke, intracerebral hemorrhage, and tumors of the brain and spinal cord.
As with past editions, I owe a debt of gratitude to many colleagues and friends, especially members of the Department of Neurology at Yale Medical School, who have liberally shared their insights and expertise and have helped to create an environment where learning is fun, a motif that I have woven into this book. I hope that readers of this book will join me in finding that neuroanatomy, which provides much of the foundation for both basic neuroscience and clinical medicine, can be enjoyable, memorable, and easily learned.