There are many extraordinary neurology and neuroanatomy textbooks. Innumerable clinical pearls can be gleaned from dedicated time spent with these texts as a student, trainee, and practitioner. Yet when I was a student and then a trainee, I found that there was no single text that provided a comprehensive introduction to clinical neuroanatomy, its application to neurology, and the diagnosis and management of both common and rare neurologic diseases in one concise volume. I had wished that there was a book that could be read cover-to-cover as a student rotating through neurology, or when I was a soon-to-be neurology resident at the end of my medical internship, or as a quick reference to efficiently review topics as a neurology resident—a book in which one or more chapters could be read in a single sitting. As I began to teach neuroanatomy and neurology to students, residents, and non-neurologists, I learned that they too wished for such a book. In Clinical Neurology & Neuroanatomy: A Localization-Based Approach, I decided to attempt to write that book.
Some of the many essential textbooks that nearly all neurologists return to throughout training and practice include Brazis’ Localization in Clinical Neurology, Patten’s Neurologic Differential Diagnosis, and Blumenfeld’s Neuroanatomy through Clinical Cases for neurologic localization and clinical neuroanatomy; Adams and Victor’s Principles of Neurology and Bradley’s Neurology in Clinical Practice for clinical neurology. Clinical Neurology & Neuroanatomy: A Localization-Based Approach is, by design, a fraction of the size of any one of these books, and is meant to provide a concise but comprehensive framework to facilitate engagement with those texts. My goal is to distill clinical neuroanatomy, clinical neurology, and their interrelations to their fundamental principles so as to explain them clearly and simply. In so doing, I hope to convey the core material essential to the practice of neurology in an efficient and easily digestible format with the depth and detail required of neurology residents and neurologists reviewing for recertification examinations, but also with sufficient clarity and brevity for medical students on neurology rotations and non-neurologists in settings where there are few or no neurologists.
In Part 1 of this book, clinically relevant neuroanatomy is presented in clinical context in order to provide a framework for neurologic localization and differential diagnosis. The diseases mentioned in localization-based discussions of differential diagnoses in Part 1 are then discussed in clinical detail with respect to their diagnosis and management in Part 2. For example, in Chapter 5, the anatomy of the spinal cord and its relation to clinical syndromes involving the spinal cord are discussed. The differential diagnosis of myelopathy is presented, but the evaluation and management of many of the diseases mentioned that can cause myelopathy are discussed in Part 2 (e.g., vascular diseases of the spinal cord are discussed in Ch. 19, infections of the spine in Ch. 20, inflammatory conditions of the spinal cord in Ch. 21). Part 1 of this book can therefore be consulted for a neuroanatomical localization-based approach to symptom evaluation, and Part 2 for the clinical features, diagnosis, and management of neurologic diseases. Certain diseases are more logically discussed directly in the context of their underlying anatomy, and where this is the case, these diseases are discussed in Part 1 (e.g., trigeminal neuralgia and Bell’s palsy in Ch. 13 on the trigeminal and facial nerves; benign paroxysmal positional vertigo in Ch. 12 on the vestibular system and the approach to vertigo).
Neurology is learned by taking care of patients: thinking through localization and differential diagnosis, evaluation, and management of individual patients, and discussing these patients’ cases with one’s clinical teachers and colleagues. This book is of course no replacement for that experience. However, my hope is that this book will serve as a guide to and through that process.
Aaron L. Berkowitz, MD, PhD