In the past two decades, the increasing spatial and contrast resolution of modern imaging techniques has vastly expanded the scope of what we can see, and hence, of what we must know. The past dozen years of teaching radiology residents, neurology residents, and neuroradiology fellows has convinced me that this is particularly true in neuroimaging, and applies both to the depth and the scope of our requisite knowledge base. The ability of MRI to show precise neuroanatomical details has made the practices of neurology and neuroradiology more intertwined than ever before. This, in turn, makes it necessary for neuroradiologists to learn more neurology and for neurologists to learn more neuroradiology than practitioners of a generation ago.
This book seeks to fulfill that aim. Focusing on the intersection between these two closely related specialties, it attempts to bridge a gap sometimes found in the many excellent standard textbooks in both fields – an insufficient stress on the overlap between them.
To give a rudimentary example, when a neurologist comes down to radiology stating that he has a patient with internuclear ophthalmoplegia (INO), the neuroradiologist needs to recognize the syndrome, understand its underlying neuroanatomic substratum, and look carefully in the brainstem tegmentum for the small lesion involving the medial longitudinal fasciculus which might otherwise be missed. Conversely, when a neuroradiologist proclaims to his neurology colleagues that a parkinsonian patient’s MRI scan shows the stigmata of multiple system atrophy (MSA), they would like to be familiar enough with the particulars of MRI to recognize those stigmata. Thus, this book attempts to provide imaging correlates for typical cases seen in neurology and clinical correlates for the findings made with neuroimaging.
The book is divided into individual chapters, from the cerebellum through the brainstem, diencephalon, basal ganglia, and cortex. Each chapter provides a discussion of the clinically relevant neuroanatomy of that part of the brain. Following this introductory discussion, structure–function correlations in the CNS are illustrated through consideration of actual clinical cases. The cases are presented in an interactive question–answer ‘‘noon conference’’ format, leading from the clinical history to a presentation of imaging findings and a discussion of the relationship between those findings and the patient’s clinical deficits. This format allows neuroanatomical details to take on an immediate clinical relevance, thus making them easier to remember, and also allows the clinician to appreciate the elegance and specificity of modern neuroimaging. By its very nature – i.e., a case-based approach – this is not meant to be a comprehensive text. However, it attempts to present many of the common entities seen in a hospital-based neurology practice in some detail, and to enhance these presentations with discussions of the relevant neuronal circuitry, pertinent neurochemistry and sometimes the basic therapeutic approaches to particular syndromes of the CNS. Since many of the structure–function correlations are best displayed with stroke cases, the book ends with a detailed chapter on imaging in stroke and the role of imaging in stroke therapy.
Contents
1 The cerebellum
Introduction
Anatomic overview
Cytoarchitecture
Macroscopic organization
Functional zones and clinical correlations
2 The medulla
Level of the pyramidal decussation
Level of sensory (lemniscal) decussation
Level of the inferior olives and inferior cerebelar peduncles
3 The pons
Anatomy
The basis pontis
The corticospinal tract
Corticobulbar fibers
Corticocerebellar fibers (corticopontine fibers with connections to the cerebellar hemispheres)
The pontine tegmentum
The reticular formation
The sensory lemniscal system
The trapezoid body
The medial longitudinal fasciculus (MLF)
The locus ceruleus
Cranial nerve nuclei
4 The midbrain
Midbrain anatomy
Anatomy of the caudal midbrain
Anatomy of the rostral midbrain
Midbrain blood supply
5 The basal ganglia
Definition and nomenclature of the basal ganglia
A general overview of basal ganglia connectivity
A few facts about basal ganglia neurons
A slightly more detailed view of basal ganglia connectivity
Minor outputs of the basal ganglia motor loop
Other cortex–striatum loops and other basal ganglia functions
6 The diencephalon
The thalamus
7 The cerebral cortex
Neocortex
Allocortex
Mesocortex
Primary cortical areas
Unimodal association areas
Multimodal association areas
The limbic cortex
8 Stroke – imaging and therapy
Introduction
Basics of stroke imaging
Hypodensity of the gray matter and loss of the gray–white matter differentiation
Dense vessels indicating intravascular clot
MRI in stroke
Diffusion-weighted (DWI) MRI
Stroke therapy
Intravenous thrombolysis: the basics
Intra-arterial thrombolysis
Combination of intra-arterial and intravenous (bridging) thrombolytic therapy
Alternative thrombolytic agents
Mechanical clot retrieval
Extending the thrombolysis time window: diffusion–perfusion MRI and the ischemic penumbra model
Refining the PWI–DWI mismatch model: DWI reversibility and infarct threshold analysis
Index
Color plates will be found between p. xii and p. 1.
This book seeks to fulfill that aim. Focusing on the intersection between these two closely related specialties, it attempts to bridge a gap sometimes found in the many excellent standard textbooks in both fields – an insufficient stress on the overlap between them.
To give a rudimentary example, when a neurologist comes down to radiology stating that he has a patient with internuclear ophthalmoplegia (INO), the neuroradiologist needs to recognize the syndrome, understand its underlying neuroanatomic substratum, and look carefully in the brainstem tegmentum for the small lesion involving the medial longitudinal fasciculus which might otherwise be missed. Conversely, when a neuroradiologist proclaims to his neurology colleagues that a parkinsonian patient’s MRI scan shows the stigmata of multiple system atrophy (MSA), they would like to be familiar enough with the particulars of MRI to recognize those stigmata. Thus, this book attempts to provide imaging correlates for typical cases seen in neurology and clinical correlates for the findings made with neuroimaging.
The book is divided into individual chapters, from the cerebellum through the brainstem, diencephalon, basal ganglia, and cortex. Each chapter provides a discussion of the clinically relevant neuroanatomy of that part of the brain. Following this introductory discussion, structure–function correlations in the CNS are illustrated through consideration of actual clinical cases. The cases are presented in an interactive question–answer ‘‘noon conference’’ format, leading from the clinical history to a presentation of imaging findings and a discussion of the relationship between those findings and the patient’s clinical deficits. This format allows neuroanatomical details to take on an immediate clinical relevance, thus making them easier to remember, and also allows the clinician to appreciate the elegance and specificity of modern neuroimaging. By its very nature – i.e., a case-based approach – this is not meant to be a comprehensive text. However, it attempts to present many of the common entities seen in a hospital-based neurology practice in some detail, and to enhance these presentations with discussions of the relevant neuronal circuitry, pertinent neurochemistry and sometimes the basic therapeutic approaches to particular syndromes of the CNS. Since many of the structure–function correlations are best displayed with stroke cases, the book ends with a detailed chapter on imaging in stroke and the role of imaging in stroke therapy.
Contents
1 The cerebellum
Introduction
Anatomic overview
Cytoarchitecture
Macroscopic organization
Functional zones and clinical correlations
2 The medulla
Level of the pyramidal decussation
Level of sensory (lemniscal) decussation
Level of the inferior olives and inferior cerebelar peduncles
3 The pons
Anatomy
The basis pontis
The corticospinal tract
Corticobulbar fibers
Corticocerebellar fibers (corticopontine fibers with connections to the cerebellar hemispheres)
The pontine tegmentum
The reticular formation
The sensory lemniscal system
The trapezoid body
The medial longitudinal fasciculus (MLF)
The locus ceruleus
Cranial nerve nuclei
4 The midbrain
Midbrain anatomy
Anatomy of the caudal midbrain
Anatomy of the rostral midbrain
Midbrain blood supply
5 The basal ganglia
Definition and nomenclature of the basal ganglia
A general overview of basal ganglia connectivity
A few facts about basal ganglia neurons
A slightly more detailed view of basal ganglia connectivity
Minor outputs of the basal ganglia motor loop
Other cortex–striatum loops and other basal ganglia functions
6 The diencephalon
The thalamus
7 The cerebral cortex
Neocortex
Allocortex
Mesocortex
Primary cortical areas
Unimodal association areas
Multimodal association areas
The limbic cortex
8 Stroke – imaging and therapy
Introduction
Basics of stroke imaging
Hypodensity of the gray matter and loss of the gray–white matter differentiation
Dense vessels indicating intravascular clot
MRI in stroke
Diffusion-weighted (DWI) MRI
Stroke therapy
Intravenous thrombolysis: the basics
Intra-arterial thrombolysis
Combination of intra-arterial and intravenous (bridging) thrombolytic therapy
Alternative thrombolytic agents
Mechanical clot retrieval
Extending the thrombolysis time window: diffusion–perfusion MRI and the ischemic penumbra model
Refining the PWI–DWI mismatch model: DWI reversibility and infarct threshold analysis
Index
Color plates will be found between p. xii and p. 1.
Book Details
- Hardcover: 288 pages
- Publisher: Cambridge University Press; 1 edition
- Language: English
- ISBN-10: 0521600545
- ISBN-13: 978-0521600545
- Product Dimensions: 10.9 x 8.6 x 0.9 inches