Offering a concise, highly visual approach to the basic science and clinical pathology of the nervous system, this updated volume in The Netter Collection of Medical Illustrations (the CIBA "Green Books") contains unparalleled didactic illustrations reflecting the latest medical knowledge. Revised by Drs. Michael J. Aminoff, Scott L. Pomeroy, and Kerry H. Levin, Brain, Part 1 of the Nervous System, Volume 7,integrates core concepts of anatomy, physiology, and other basic sciences with common clinical correlates across health, medical, and surgical disciplines. Classic Netter art, updated and new illustrations, and modern imaging continue to bring medical concepts to life and make this timeless work an essential resource for students, clinicians, and educators.
Provides a highly visual guide to this complex organ, from basic neurodevelopment, neuroanatomy, neurophysiology, and cognition to a full range of disorders, including epilepsy, disorders of consciousness and sleep, movement disorders, stroke, multiple sclerosis, neurologic infections, neuro-oncology, headaches, and brain trauma
Offers expanded coverage of timely topics like acute flaccid paralysis; neurological complications of COVID-19, ependymomas, genetics of epilepsy, and more
Provides a concise overview of complex information by seamlessly integrating anatomical and physiological concepts using practical clinical scenarios
Shares the experience and knowledge of Drs. Michael J. Aminoff, Scott L. Pomeroy, and Kerry H. Levin, with content overseen by experts at Harvard, UCSF, and other leading neurology centers
Compiles Dr. Frank H. Netter’s master medical artistry—an aesthetic tribute and source of inspiration for medical professionals for over half a century—along with new art in the Netter tradition for each of the major body systems, making this volume a powerful and memorable tool for building foundational knowledge and educating patients or staff
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SECTION 1. NORMAL AND ABNORMAL DEVELOPMENT 1.1 Embryo at 18 Days 1.2 Embryo at 20 to 24 Days 1.3 Central Nervous System at 28 Days 1.4 Central Nervous System at 36 Days 1.5 Defective Neural Tube Formation 1.6 Defective Neural Tube Formation (Continued) 1.7 Spinal Dysraphism 1.8 Spinal Dysraphism (Continued) 1.9 Fetal Brain Growth in the First Trimester 1.10 Craniosynostosis 1.11 Extracranial Hemorrhage and Skull Fractures in the Newborn 1.12 Intracranial Hemorrhage in the Newborn 1.13 External Development of the Brain in the Second and Third Trimesters 1.14 Mature Brain Ventricles 1.15 Hydrocephalus 1.16 Surgical Treatment of Hydrocephalus 1.17 Cerebral Palsy 1.18 Establishing Cellular Diversity in the Embryonic Brain and Spinal Cord 1.19 Generation of Neuronal Diversity in the Spinal Cord and Hindbrain 1.20 Circuit Formation in the Spinal Cord 1.21 Sheath and Satellite Cell Formation 1.22 Development of Myelination and Axon Ensheathment 1.23 Brachial Plexus and/or Cervical Nerve Root Injuries at Birth 1.24 Morphogenesis and Regional Differentiation of the Forebrain 1.25 Neurogenesis and Cell Migration in the Developing Neocortex 1.26 Neuronal Proliferation and Migration Disorders 1.27 Developmental Dyslexia 1.28 Autism Spectrum Disorders 1.29 Rett Syndrome 1.30 Rett Syndrome (Continued)
SECTION 2. CEREBRAL CORTEX AND NEUROCOGNITIVE DISORDERS 2.1 Surfaces of Cerebrum: Superolateral Surface 2.2 Surfaces of Cerebrum: Medial Surface 2.3 Surfaces of Cerebrum: Inferior Surface 2.4 Cerebral Cortex: Function and Association Pathways 2.5 Major Cortical Association Bundles 2.6 Corticocortical and Subcorticocortical Projection Circuits 2.7 Corpus Callosum 2.8 Rhinencephalon and Limbic System 2.9 Hippocampus 2.10 Fornix 2.11 Amygdala 2.12 Forebrain Regions Associated With Hypothalamus 2.13 Thalamocortical Radiations 2.14 Neuronal Structure and Synapses 2.15 Chemical Synaptic Transmission 2.16 Summation of Excitation and Inhibition 2.17 Types of Neurons in Cerebral Cortex 2.18 Astrocytes 2.19 Testing for Defects of Higher Cortical Function 2.20 Memory Circuits 2.21 Amnesia 2.22 Dominant Hemisphere Language Dysfunction 2.23 Nondominant Hemisphere Higher Cortical Dysfunction 2.24 Alzheimer Disease: Pathology 2.25 Alzheimer Disease: Distribution of Pathology 2.26 Alzheimer Disease: Clinical Manifestations, Progressive Phases 2.27 Frontotemporal Dementia 2.28 Dementia with Lewy Bodies 2.29 Vascular Dementia 2.30 Treatable Dementias 2.31 Normal-Pressure Hydrocephalus
SECTION 3. EPILEPSY 3.1 Electroencephalography 3.2 Focal (Partial) Seizures 3.3 Generalized Tonic-Clonic Seizures 3.4 Absence Seizures 3.5 Epilepsy Syndromes 3.6 Neonatal Seizures 3.7 Status Epilepticus 3.8 Causes of Seizures 3.9 Neurobiology of Epilepsy: Ion channels 3.10 Neurobiology of Epilepsy: Synaptic Receptors 3.11 Neurobiology of Epilepsy: Antiepileptic Drug Targets 3.12 Treatment of Epilepsy: Preoperative Evaluation 3.13 Treatment of Epilepsy: Resective Surgery
SECTION 4. PSYCHIATRY 4.1 Limbic System 4.2 Major Depressive Disorder 4.3 Postpartum Depression 4.4 Bipolar Disorder 4.5 Bipolar Disorder (Continued) 4.6 Generalized Anxiety Disorder 4.7 Social Anxiety Disorder 4.8 Panic Disorder 4.9 Posttraumatic Stress Disorder 4.10 Obsessive-Compulsive Disorder 4.11 Somatization 4.12 Conversion Disorder 4.13 Schizophrenia 4.14 Alcohol Use Disorder 4.15 Treatment for Alcohol Use Disorder 4.16 Alcohol Withdrawal 4.17 Opioid Use Disorders: Brain Substrates of Addictive Behaviors 4.18 Opioid Use Disorders: Overdose Reversal 4.19 Opioid Withdrawal 4.20 Borderline Personality Disorder 4.21 Antisocial Personality Disorder 4.22 Intimate Partner Violence 4.23 Abuse in Later Life 4.24 Delirium and Acute Personality Changes 4.25 Delirium and Acute Personality Changes (Continued) 4.26 Insomnia 4.27 Pediatrics: Depressive Disorders 4.28 Pediatrics: Anxiety Disorders 4.29 Pediatrics: Disruptive Behavior Disorders 4.30 Pediatrics: Attention-Deficit/Hyperactivity Disorders 4.31 Pediatrics: Eating and Feeding Disorders 4.32 Child Abuse: Fractures in Abused Children 4.33 Child Abuse: Staging of Injuries and Injury Patterns
SECTION 5. HYPOTHALAMUS, PITUITARY, SLEEP, AND THALAMUS 5.1 Anatomic Relationships of the Hypothalamus 5.2 Development and Developmental Disorders of the Hypothalamus 5.3 Blood Supply of the Hypothalamus and Pituitary Gland 5.4 General Topography of the Hypothalamus 5.5 Overview of Hypothalamic Nuclei 5.6 Hypothalamic Control of the Pituitary Gland 5.7 Hypothalamic Control of the Autonomic Nervous System 5.8 Olfactory Inputs to the Hypothalamus 5.9 Visual Inputs to the Hypothalamus 5.10 Somatosensory Inputs to the Hypothalamus 5.11 Taste and Other Visceral Sensory Inputs to the Hypothalamus 5.12 Limbic and Cortical Inputs to the Hypothalamus 5.13 Overview of Hypothalamic Function and Dysfunction 5.14 Regulation of Water Balance 5.15 Temperature Regulation 5.16 Fever: Cytokines and Prostaglandins Cause the Sickness Response 5.17 Fever: Hypothalamic Responses During Inflammation Modulate Immune Response 5.18 Regulation of Food Intake, Body Weight, and Metabolism 5.19 Stress Response 5.20 Hypothalamic Regulation of Cardiovascular Function 5.21 Hypothalamic Regulation of Sleep 5.22 Narcolepsy: A Hypothalamic Sleep Disorder 5.23 Sleep-Disordered Breathing 5.24 Parasomnias 5.25 Divisions of the Pituitary Gland and Its Relationships to the Hypothalamus 5.26 Posterior Pituitary Gland 5.27 Anatomic Relationships of the Pituitary Gland 5.28 Effects of Pituitary Mass Lesions on the Visual Apparatus 5.29 Anterior Pituitary Hormone Deficiencies 5.30 Severe Anterior Pituitary Hormone Deficiencies (Panhypopituitarism) 5.31 Postpartum Pituitary Infarction (Sheehan Syndrome) 5.32 Pituitary Apoplexy 5.33 Thalamic Anatomy and Pathology 5.34 Thalamic Anatomy and Pathology (Continued)
SECTION 6. DISORDERS OF CONSCIOUSNESS (COMA) 6.1 Coma 6.2 Disorders of Consciousness 6.3 Emergency Management: Full Outline of Unresponsiveness Score (FOUR) 6.4 Emergency Management: Prognosis in Coma Related to Severe Head Injuries 6.5 Differential Diagnosis of Coma 6.6 Hypoxic-Ischemic Brain Damage 6.7 Vegetative State, Minimally Conscious State, and Unresponsive Wakefulness Syndrome 6.8 Brain Death or Death by Neurologic Criteria 6.9 Ventilatory Patterns and the Apnea Test
SECTION 7. BASAL GANGLIA AND MOVEMENT DISORDERS 7.1 Basal Nuclei (Ganglia) 7.2 Basal Ganglia and Related Structures 7.3 Schematic and Cross Section of Basal Ganglia 7.4 Parkinsonism: Early Manifestations 7.5 Parkinsonism: Successive Clinical Stages 7.6 Neuropathology of Parkinson Disease 7.7 Progressive Supranuclear Palsy 7.8 Corticobasal Degeneration 7.9 Parkinsonism: Hypothesized Role of Dopamine 7.10 Surgical Management of Movement Disorders 7.11 Hyperkinetic Movement Disorder: Idiopathic Torsion Dystonia 7.12 Hyperkinetic Movement Disorder: Cervical Dystonia 7.12 Chorea/Ballism 7.13 Tremor 7.14 Tics and Tourette Syndrome 7.15 Myoclonus 7.17 Wilson Disease 7.18 Psychogenic Movement Disorders 7.19 Cerebral Palsy
SECTION 8. CEREBELLUM AND ATAXIA 8.1 Cerebellum and the Fourth Ventricle 8.2 Cerebellum Gross Anatomy 8.3 Cerebellar Peduncles 8.4 Cerebellar Cortex and Nuclei: Neuronal Elements 8.5 Cerebellar Cortex: Neuronal Elements 8.6 Cerebellar Cortical and Corticonuclear Circuitry: Cerebellar Neuronal Circuitry 8.7 Cerebellar Cortical and Corticonuclear Circuitry: Circuit Diagram of Afferent Connections 8.8 Cerebellum Subdivisions and Afferent Pathways 8.9 Cerebellum Subdivisions and Afferent Pathways: Spinocerebellar Pathways 8.10 Cerebellar Efferent Pathways 8.11 Cerebellovestibular Pathways 8.12 Cerebellum Modular Organization 8.13 Cerebrocerebellar Connections 8.14 Cerebellar Motor Examination 8.15 Cerebellar Cognitive Affective Syndrome 8.16 Cerebellar Disorders: Differential Diagnosis I 8.17 Gait Disorders: Differential Diagnosis II 8.18 Gait Disorders: Differential Diagnosis III 8.19 Friedreich Ataxia 8.20 Friedreich Ataxia: Cardiac Abnormalities and GAA Expansion Mutation
SECTION 9. CEREBROVASCULAR CIRCULATION AND STROKE Overview and Approach to Stroke Patient 9.1 Arteries to Brain: Schema 9.2 Arteries to Brain and Meninges 9.3 Temporal and Infratemporal Fossae 9.4 Territories of the Cerebral Arteries 9.5 Arteries of Brain: Lateral and Medial Views 9.6 Arteries of Brain: Frontal View and Section 9.7 Types of Stroke 9.8 Temporal Profile of Transient Ischemic Attack (TIA) and Completed Infarction 9.9 Clinical Evaluation and Treatment of Stroke 9.10 Clinical Evaluation and Treatment of Stroke (Continued) 9.11 Uncommon Etiologic Mechanisms of Stroke Anterior Circulation Ischemia 9.12 Common Sites of Cerebrovascular Occlusive Disease 9.13 Other Etiologies of Carotid Artery Disease 9.14 Clinical Manifestations of Carotid Artery Disease 9.15 Occlusion of Middle and Anterior Cerebral Arteries 9.16 Diagnosis of Internal Carotid Disease 9.17 Diagnosis of Carotid Artery Disease 9.18 Carotid Endarterectomy 9.19 Endovascular ICA Angioplasty and Stenting Using a Protective Device Vertebral Basilar System Disorders 9.20 Arterial Distribution to the Brain: Basal View 9.21 Arteries of Posterior Cranial Fossa 9.22 Clinical Manifestations of Vertebrobasilar Territory Ischemia 9.23 Intracranial Occlusion of Vertebral Artery 9.24 Occlusion of Basilar Artery and Branches 9.25 Occlusion of Top-of-the-Basilar and Posterior Cerebral Arteries Brain Emboli 9.26 Cardiac Sources of Brain Emboli 9.27 Uncommon Cardiac Mechanisms in Stroke Lacunar Stroke 9.28 Lacunar Infarction 9.29 Risk Factors for Cardiovascular Disease Other 9.30 Hypertensive Encephalopathy 9.31 Hypoxia Coagulopathies 9.32 Role of Platelets in Arterial Thrombosis 9.33 Inherited Thrombophilias 9.34 Antiphospholipid Antibody Syndrome Venous Sinus Thrombosis 9.35 Meninges and Superficial Cerebral Veins 9.36 Intracranial Venous Sinuses 9.37 Diagnosis of Venous Sinus Thrombosis Intracerebral Hemorrhage 9.38 Pathogenesis and Types 9.39 Clinical Manifestations of Intracerebral Hemorrhage Related to Site 9.40 Vascular Malformations Intracranial Aneurysms and Subarachnoid Hemorrhage 9.41 Distribution and Clinical Manifestations of Congenital Aneurysm Rupture 9.42 Giant Congenital Aneurysms 9.43 Ophthalmologic Manifestations of Cerebral Aneurysms 9.44 Approach to Internal Carotid Aneurysms 9.45 Flow Diversion Stent for Treatment of Unruptured Intracranial Aneurysm Pediatrics 9.46 Pediatric Cerebrovascular Disease Rehabilitation 9.47 Introduction and Initial Stroke Rehabilitation 9.48 Aphasia Rehabilitation 9.49 Other Rehabilitative Issues: Gait Training, Upper Limb Function, Locked-in Syndrome 9.50 Other Rehabilitative Issues: Dysphagia
SECTION 10. MULTIPLE SCLEROSIS AND OTHER CENTRAL NERVOUS SYSTEM AUTOIMMUNE DISORDERS Multiple Sclerosis 10.1 Overview 10.2 Clinical Manifestations 10.3 Diagnosis: Typical MRI Findings—Brain 10.4 Diagnosis: Typical MRI Findings—Spinal Cord 10.5 Diagnosis: Visual Evoked Potential and Spinal Fluid Analysis 10.6 Pathophysiology 10.7 Pathophysiology (Continued) 10.8 Relapses: Steps 1 to 5 10.9 Relapses: Step 6 10.10 Relapses: Steps 7 to 8 10.11 Relapses: Consequences 10.12 Enigma of Progressive Multiple Sclerosis 10.13 Pathology 10.14 Treatment Neuroimmunologic Syndromes 10.15 Neuromyelitis Optica, Acute Disseminated Encephalomyelitis, and Acute Hemorrhagic Leukoencephalitis—Radiologic Findings 10.16 Neuromyelitis Optica, Acute Disseminated Encephalomyelitis, and Acute Hemorrhagic Leukoencephalitis—Histopathologic Findings 10.17 Introduction to Autoimmune Neurologic Syndromes 10.18 Stiff-Person Syndrome Spectrum Disorder 10.19 Autoimmune and Paraneoplastic Neurologic Syndromes 10.20 Autoimmune and Paraneoplastic Neurologic Syndromes (Continued) 10.21 Autoimmune Neurologic Syndromes: Central and Peripheral Nervous System Manifestations 10.22 Autoimmune Neurologic Syndromes: Central and Peripheral Nervous System Manifestations (Continued)
SECTION 11. INFECTIONS OF THE NERVOUS SYSTEM 11.1 Bacterial Meningitis I 11.2 Bacterial Meningitis II 11.3 Brain Abscess 11.4 Parameningeal Infections 11.5 Infections in the Immunocompromised Host: Progressive Multifocal Leukoencephalopathy and Nocardiosis 11.6 Infections in the Immunocompromised Host: Listeriosis and Toxoplasmosis 11.7 Neurocysticercosis 11.8 Spirochetal Infections: Neurosyphilis 11.9 Spirochetal Infections: Lyme Disease 11.10 Tuberculosis of Brain and Spine 11.11 Tetanus 11.12 Aseptic Meningitis and Select Arthropod-Borne Virus Infections 11.13 Human Immunodeficiency Virus: Primary Infection of the Nervous System 11.14 Human Immunodeficiency Virus: Life Cycle and Antiretroviral Medications 11.15 Poliomyelitis 11.16 Acute Flaccid Paralysis 11.17 Herpes Zoster 11.18 Herpes Simplex Virus Encephalitis and Rabies 11.19 Parasitic Infections: Cerebral Malaria and African Trypanosomiasis 11.20 Parasitic Infections: Trichinosis (Trichinellosis) 11.21 Parasitic Infections: Cryptococcal Meningitis 11.22 Creutzfeldt-Jakob Disease 11.23 Neurosarcoidosis 11.24 Neurologic Complications of COVID-19
SECTION 13. HEADACHE 13.1 Overview of Headaches 13.2 Migraine Pathophysiology 13.3 Migraine Presentation 13.4 Migraine Aura 13.5 Migraine Management 13.6 Trigeminal Autonomic Cephalagias: Cluster Headache 13.7 Trigeminal Autonomic Cephalagias: Paroxysmal Hemicrania 13.8 Tension-Type Headache and Other Benign Episodic and Chronic Headaches 13.9 Pediatric Headache 13.10 Cranial Neuralgias: Trigeminal Neuralgia 13.11 Other Cranial Neuralgias 13.12 Idiopathic Intracranial Hypertension, Pseudotumor Cerebri 13.13 Intracranial Hypotension/Low Cerebrospinal Fluid Pressure Headache 13.14 Giant Cell Arteritis 13.15 Contiguous Structure Headaches 13.16 Thunderclap Headache and Other Headaches Presenting in the Emergency Department 13.17 Headaches Presenting in the Emergency Department (Continued) 13.18 Headaches Presenting in the Emergency Department (Continued) 13.19 Headaches Presenting in the Emergency Department (Continued)
SECTION 14. HEAD TRAUMA 14.1 Skull: Anterior View 14.2 Skull: Lateral View 14.3 Skull: Midsagittal Section 14.4 Calvaria 14.5 External Aspect of Skull Base 14.6 Internal Aspects of Base of Skull: Bones 14.7 Internal Aspects of Base of Skull: Orifices 14.8 Skull Injuries 14.9 Concussion 14.10 Acute Epidural Hematoma 14.11 Acute Subdural Hematoma 14.12 CT Scans and MR Images of Intracranial Hematomas 14.13 Vascular Injury 14.14 Glasgow Coma Score 14.15 Initial Assessment and Management of Head Injury 14.16 Neurocritical Care and Management After Traumatic Brain Injury: Devices for Monitoring Intracranial Pressure 14.17 Neurocritical Care and Management: Decompressive Craniectomy
Michael J. Aminoff, MD, DSc, FRCP, Distinguished Professor Emeritus in Neurology; University of California San Francisco, USA, Scott Pomeroy, MD, PhD, Bronson Crothers Professor, Department of Neurology, Harvard Medical School; Consultant, Pediatric Oncology, Dana-Farber Cancer Institute; Neurologist-in-Chief, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA and Kerry H. Levin, MD, Chair, Department of Neurology, Director of the Neuromuscular Center at the Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
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