Neuroanatomical Basis of Clinical Neurology

504 Pages·2014·14.009 MB·English

by  Arslan, Orhan

Neurology
Arslan
NEUROANATOMICAL NEUROANATOMICAL
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BASIS of f
BASIS of

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CLINICAL NEUROLOGY
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CLINICAL NEUROLOGY
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S e c o n d E d i t i o n NO
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Bridging the gap between the peripheral and central nervous systems, the second edition of Neuroanatomical
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Basis of Clinical Neurology enriches understanding of neurological conditions through a conceptual approach
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to neuronal circuitry. The book retains the basic outline of contents from the first edition, integrating structural
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organization with pertinent clinical disorders, while reflecting the substantial growth and ever-changing L
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information in neuroscience.

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After an introduction to the developmental and cellular aspects of the nervous system, the book discusses in
depth the morphology and internal organization of the central nervous system. It examines the somatic and EM
autonomic components of the peripheral nervous system, emphasizing nerve entrapments and neuropathies.
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The author describes various dysfunctions by demonstrating the neuronal interconnectivity between higher and
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lower autonomic centers and the mediation of visceral reflexes.
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The Second Edition incorporates and highlights common and relevant clinical conditions. Topics include OA
• Various forms of cortical dysfunctions, such as seizures, disconnection syndrome, coma, and dementia LL
• The role of prefrontal cortex in behavior and attention, introducing the topic of autism O
• Up-to-date information on the auditory, vestibular, gustatory, and limbic systems B
• The neurochemistry of the limbic system, memory and associated disorders, and the structural and GA
neuronal circuitry of the hippocampal gyrus
• Structural organization and associated pathways of the extrapyramidal system, demonstrating the YS
neurochemical basis of movement disorders I
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This new edition skillfully integrates over a decade of discovery in neuroscience since the publication of the
first edition and introduces deepened insights into the neuronal synaptic connectivity and the mechanisms that
underlie neurologic disorders. The book remains an essential source of information for medical and allied health
students, practitioners of neurology, and students of neuroscience.
About the Author
Orhan E. Arslan, DVM, Ph.D.
Director of Advanced Neuroanatomy
Department of Pathology and Cell Biology
Morsani College of Medicine
Second
University of South Florida, Tampa, USA
Orhan E. Arslan
Edition
K12154
ISBN: 978-1-4398-4833-3
90000
9 781439 848333
NEUROANATOMICAL
BASIS of
CLINICAL NEUROLOGY
Second Edition

NEUROANATOMICAL
BASIS of
CLINICAL NEUROLOGY
Second Edition
Orhan E. Arslan
University of South Florida
Tampa, USA
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2015 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20140505
International Standard Book Number-13: 978-1-4398-4834-0 (eBook - PDF)
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This book is gratefully dedicated to my parents, Zübeyde and Inayet, and to my sister Gülşen
and brother Midhat, whose love and unwavering belief in science continue to guide me
through the complex journey of life and the perplexing mysteries of the nervous system.

Contents
Foreword ...................................................................................................................................................................................xvii
Preface........................................................................................................................................................................................xix
Acknowledgments ......................................................................................................................................................................xxi
Section i Basic neuroanatomy
Chapter 1 Developmental Aspects of the Nervous System ......................................................................................................3
Formation of the Neural Tube .................................................................................................................................3
Neural Tube Defects ................................................................................................................................................4
Development of the Brain Vesicles .......................................................................................................................10
Differentiation of the Neural Tube ........................................................................................................................10
Genetic and Molecular Aspects ............................................................................................................................12
Medulla Spinalis (Spinal Cord) .............................................................................................................................13
Myelencephalon .....................................................................................................................................................14
Metencephalon ......................................................................................................................................................15
Pons ..................................................................................................................................................................15
Cerebellum .......................................................................................................................................................15
Mesencephalon (Midbrain) ...................................................................................................................................16
Diencephalon (Thalamus, Hypothalamus, Epithalamus and Subthalamus) .........................................................16
Telencephalon (Cerebral Hemispheres, Basal Nuclei and Ventricular System) ....................................................17
Suggested Reading ................................................................................................................................................19
Chapter 2 Basic Elements of the Nervous System .................................................................................................................21
Neuroglia ...............................................................................................................................................................21
Macroglia ..........................................................................................................................................................21
Astrocytes ....................................................................................................................................................21
Oligodendrocytes .........................................................................................................................................22
Schwann Cells .............................................................................................................................................22
Ependymal Cells ..........................................................................................................................................23
Microglia ..........................................................................................................................................................23
Neurons .................................................................................................................................................................24
Soma (Perikaryon) ............................................................................................................................................24
Neuronal Processes ..........................................................................................................................................25
Dendrites ......................................................................................................................................................25
Axons ...........................................................................................................................................................25
Myelin....................................................................................................................................................................26
Neuronal Degeneration .........................................................................................................................................28
Antergrade Degeneration .................................................................................................................................28
Retrograde Degeneration ..................................................................................................................................28
Transynaptic Degeneration ...............................................................................................................................28
Functional and Clinical Consideration ..................................................................................................................29
Regeneration ..........................................................................................................................................................31
Demyelinating Metabolic Disorders .....................................................................................................................32
Classification of Neurons ......................................................................................................................................36
Synaptic Connectivity ...........................................................................................................................................37
Synaptic Disorders ............................................................................................................................................39
Suggested Reading ................................................................................................................................................41
vii
viii Contents
Section ii Morphologic and Sectional neuroanatomy
Chapter 3 Spinal Cord ............................................................................................................................................................45
Blood Supply .........................................................................................................................................................48
Venous Drainage ...................................................................................................................................................51
Internal Organization ............................................................................................................................................51
Gray Matter ......................................................................................................................................................51
White Matter ....................................................................................................................................................52
Spinal Cord Segments ...........................................................................................................................................53
Spinal Pathways .....................................................................................................................................................54
Ascending Tracts ..............................................................................................................................................54
Ascending Tracts in the Posterior Funiculus ...............................................................................................54
Ascending Tracts in the Lateral Funiculus ..................................................................................................54
Ascending Tracts in the Ventral Funiculus .................................................................................................54
Descending Tracts ............................................................................................................................................55
Descending Tracts in the Lateral Funiculus ................................................................................................55
Descending Tracts in the Ventral Funiculus ................................................................................................55
Suggested Reading ................................................................................................................................................55
Chapter 4 Brainstem ..............................................................................................................................................................57
Medulla..................................................................................................................................................................57
Fourth Ventricle.....................................................................................................................................................57
Caudal Medulla ................................................................................................................................................59
Motor Decussation Level .............................................................................................................................59
Level of Sensory Decussation ......................................................................................................................59
Midolivary Level .........................................................................................................................................60
Rostral Medulla ...........................................................................................................................................62
Pontomedullary Junction .............................................................................................................................62
Pons .......................................................................................................................................................................62
Caudal Pons ......................................................................................................................................................64
Midpons ............................................................................................................................................................65
Rostral Pons ......................................................................................................................................................66
Midbrain ................................................................................................................................................................66
Caudal Midbrain ...............................................................................................................................................68
Rostral Midbrain ..............................................................................................................................................70
Suggested Reading ................................................................................................................................................71
Chapter 5 Reticular Formation ..............................................................................................................................................73
Raphe Nuclei .........................................................................................................................................................73
Medial Reticular Zone ..........................................................................................................................................74
Ascending Reticular Activating System ................................................................................................................74
Lateral Reticular Zone ..........................................................................................................................................75
Sleep and Associated Disorders ............................................................................................................................77
Suggested Reading ................................................................................................................................................79
Chapter 6 Cerebellum ............................................................................................................................................................81
Morphologic Characteristics .................................................................................................................................81
Blood Supply and Venous Drainage .................................................................................................................83
Cerebellar Classification ...................................................................................................................................84
Cerebellar Cortex .............................................................................................................................................84
Cerebellar Nuclei ...................................................................................................................................................87
Cerebellar Afferents ..............................................................................................................................................87
Cerebellar Efferents ..............................................................................................................................................91
Contents ix
Cerebellar Circuits ................................................................................................................................................93
Cerebellovestibular Circuit ...............................................................................................................................93
Reticulocerebellar Circuit .................................................................................................................................93
Rubrocerebellar Circuit ....................................................................................................................................93
Cortico-cerebro-cerebellar Circuit ...................................................................................................................94
Intracerebellar Circuit ......................................................................................................................................95
Functional and Clinical Consideration ..................................................................................................................95
Cerebellar Lesions and Associated Diseases ........................................................................................................98
Suggested Reading ................................................................................................................................................99
Chapter 7 Diencephalon ........................................................................................................................................................101
Thalamus ..............................................................................................................................................................101
Thalamic Nuclear Group .....................................................................................................................................102
Anterior Nucleus .............................................................................................................................................103
Ventral Nuclear Group ...................................................................................................................................103
Lateral Geniculate Body (LGB) ................................................................................................................103
Medial Geniculate Body (MGB) ...............................................................................................................104
Ventral Posterior Nucleus (VPN) ..............................................................................................................104
Ventral Anterior Nucleus (VA) ..................................................................................................................105
Ventral Lateral Nucleus (VL) ....................................................................................................................106
Lateral Nuclear Group .........................................................................................................................................107
Lateral Dorsal (LD) ........................................................................................................................................107
Lateral Posterior .............................................................................................................................................107
Pulvinar ..........................................................................................................................................................107
Medial Nuclear Group .........................................................................................................................................108
Dorsomedial Nucleus .....................................................................................................................................108
Intralaminar Nuclear Group ................................................................................................................................109
Midline Nuclear Group ........................................................................................................................................110
Reticular Nuclear Group ......................................................................................................................................110
Functional and Clinical Consideration .................................................................................................................110
Hypothalamus ......................................................................................................................................................111
Hypothalamic Areas and Nuclei .....................................................................................................................112
Functional and Clinical Consideration .................................................................................................................115
Hypothalamic Afferents .......................................................................................................................................119
Hypothalamic Efferents ......................................................................................................................................120
Pituitary Gland (Hypophysis Cerebri) ................................................................................................................122
Functional and Clinical Consideration ................................................................................................................123
Epithalamus .........................................................................................................................................................123
Functional and Clinical Consideration ...........................................................................................................123
Pineal Gland ........................................................................................................................................................124
Stria Medullaris ...................................................................................................................................................125
Habenula ..............................................................................................................................................................125
Posterior Commissure .........................................................................................................................................126
Subthalamus ........................................................................................................................................................126
Suggested Reading ..............................................................................................................................................127
Chapter 8 Telencephalon ......................................................................................................................................................129
Cerebral Hemispheres .........................................................................................................................................129
General Characteristics ..................................................................................................................................129
Frontal Lobe .........................................................................................................................................................131
Prefrontal Cortex ............................................................................................................................................132
Parietal Lobe .......................................................................................................................................................134
Temporal Lobe ....................................................................................................................................................136
Functional and Clinical Consideration ...........................................................................................................136
Occipital Lobe .....................................................................................................................................................137