a LANGE medical book Clinical Neuroanatom y Twenty-SeEvdeinttiho n StehpenG .W axmanM,D ,P hD BridgMeatr iFel ahePrrtoyf esosfNo eru roloNgeyu,r obio&l oPghya,r macology DirectCoer,n tfeorNr e urosci&e Rnecgee neraRteisoena rch YalUen iverSscihtoyoo flM edicine NewH avenC,o nnecticut I NewY orCkh icaSgaoFn r ancMLieisscdboiLo ocnn adlon MadrCiidt y Mexico MilaNne w DeSlahJniu aSne oul SiSnygdanpTeooyrr eo nto Copyri©g h2t013b yM cGraw-HEidlulc atiAlolnr. i ghrtess ervEexdc.e patsp ermitutnedde trh eU niteSdt atCeosp yriAgchtto f1 976n,o p arotft hisp ublication mayb er eproduocred di stribiunat neydf ormo rb ya nym eanso,rs torienda d atabaosrre e triesvyaslt ewmi,t hotuhtep riowrr ittpeenr missoifot nh ep ublisher. ISBN9:7 8-0-07-179798-6 MI-IID: 0-07-179798-X Them ateriinat lh iesB ooka lsaop peairnst hep rintv ersioofnt hitsi tIlSeB:N 9:7 8-0-07-179797-9, MI-IID: 0-07-179797-1. Allt rademaarrkets r ademaorfkst herier spectoiwvnee rRsa.t hetrh apnu ta trademasrykm boalft eerv eroyc curreonfca e t rademarnkaemde w,e usen ameisn ane ditorfiaaslhi oonn lya,n dt ot heb enefiotft het rademaorwkn erw,i tnho i ntentoifinfrino gne ment oft het rademaWrhke.r e sduechs ignataipopnesain r t his bookt,h ehya veb eenp rintweidt ihn itciaapls . McGraw-HEidlulc ateiBoono kasr ea vailaabtsl pee ciqaula ntdiitsyc outnout ss ea sp remiuamnsd s alepsr omotioonrfs o,ur s ei nc orportartaei npirnogg raTmos . contaacr te presentpalteiavese-e m auisla tb [email protected]. Previoeudsi ticoonpsy ri©g h2t0102,0 032,0 00b yT heM cGraw-HiColmlp aniesI,n c. Notice Mediciniesa ne ver-chansgciinegn Asce n.e wr esearacnhdc liniecxaple riebnrcoea doeunr k nowledcghea,n gienst reatmaenndtdr ugt heraapryer equirTehde. authaonrd t hep ublisohfet rh iwso rkh avec heckewdi tsho urcbeesl ievteobd e r eliaibnlt eh eeiffro rttsop roviidnef ormattihoaintsc ompleatnedg enerailnl y accorwdi tthh es tandaarcdcse ptaettd h et imoef p ublication. Hovwieevwoe frt ,h ep ions sibiolfhi utmya ne rroorrc hangiensm edicsacli encneesi,t htehre authnoorr t hep ublisnhoerar n yo thepra rtwyh oh asb eeni nvolvientd h ep reparaotrip ounb licaotfit ohniw so rkw arrantthsat th ei nformatcioonnt ainheedr ein isi ne verrye speacctc uraotrce o mpleatned,t hedyi sclaailrmle sponsibfiolrai ntyey r roorrso missioonrfs o rt her esulotbst ainfreodm useo ft hei nformation contaiinnet dh iwso rkR.e adearrsee ncouratgoec do nfirtmh ein formactoinotna ihneerde wiint oht hesro urcFeosr.e xamplaen di np articurleaard,ea rrsea dvised toc hectkh ep roduicntf ormatsihoenein tc ludeidnt hep ackaogefe acdhr utgh epyl atno a dministtobe erc ertatinh atth ei nformatcioonnt ainiendt hiwso rki s accuraatnedt hacth angheasv en otb eenm adei nt her ecommenddeods eo ri nt hec ontraindicfaotrai domnisn istrTahtiirsoe nc.o mmendatiisoo nfp articular importainncc eo nnectwiiotnnh e wo ri nfrequenutsleydd r ugs. TERMSO F USE Thiiss a copyrighwtoerdka ndM cGraw-Hill EduLcLaCt.ai nodni ,tl si censroersse ravlerl i ghitnsa ndt ot hew orkU.s eo ft hiwso rki ss ubjetcott h estee rms. Excepatsp ermitutnedde trh eC opyrigAhctto f1 976a ndt her ighttos toraen dr etrioenveec opyo ft hew orky,o um ayn otd ecompile, disassemble, reverse engineer, rempordoidfyuc,cr ee,a dteer ivawtoirvkebs a seudp ont,r ansmdiits,t ribute, disseslpelum,bi lniaostrhes u,b licetnhsewe o rko ra nyp arotf i tw ithout McGraw-Hill Edupcraitociroo nns'esnY to.um ayu set ilew orkf ory ouorw nn oncommercainadpl e rsonuaslea ;n yo theurs eo ft hew orki ss trictplryo hibited. Yourr ightotu set hew orkm ayb et erminaitfye odu f aitloc omplwyi tthh estee rms. THE WORK ISP ROVIDED "ASI S.M"c GRAW-HILELD UCATION AND ITS LICENSORMAKES NO GUARANTEESO R WARRANTIESA S TO THE ACCURACY,A DEQUACY OR COMPLETENESSO F OR RESULTST O BE OBTAINEDF ROM USINGT HE WORK,I NCLUDINGANY INFORMATION THAT CAN BE ACCESSEDT HROUGH THE WORK VIA HYPERLINKO R OTHERWISEAND, EXPRESSLYD ISCLAIM ANY WARRANTY,E XPRESS OR IMPLIED,IN CLUDING BUT NOT LIMITED TO IMPLIED WARRAN TIESO F MERCHANTABILITYO R FITNESFSO RA PARTICULARP URPOSE. McGraw-HiEdlulc atiaonndi tlsi censdoorn so tw arraonrtg uaranttheaett h ef uncticoonnst aiinnet dh ew orkw ilmle ety ourre quiremoernt thsai tt osp eration wilble u ninterrupotree dr rofrre eN.e ithMecrG raw-HiEldlu catinoonri tlsi censsohraslb lel iabtloey ouo ra nyoneel sfeo ra nyi naccurearcryoo,rr o mission, regardolfec sasu sien,t hew orko rf oarn yd amagerse sulttinhge refroMmc.G raw-HEidlulc atihoansn or esponsifboitlrhi ecto yn teonfat n yi nformaatcicoens sed throutghhew orkU.n denro c ircumstasnhcaeMlscl G raw-HEidlulc atainod/no irt lsi censboelr isa bfloear n yi ndirienccti,d enstpaelc,ip auln,i ticvoen,s equential ors imildaarm agetsh arte sufrlotm theu seo fo ri nabiltiou tsyet hew orke,v eni fa nyo ft hemh asb eena dvisoefdt hep ossibiolfsi utcydh a mageTsh.i lsi mitation ofl iabislhiatlaylp pltyoa nyc laiomr c ausweh atsoewvheert hseurc chl aiomrc ausaer isine cs ontratcotro,tr o therwise. FoWre nadnyRd o sanleilwei ,gi hnmty ls if e. KeyF eatuorfte hsEi dsi tion! 300f+u ll-coillolru strations • Large8r% 11t rismi zce omplemetnhten ewf ull-caorlto r • Discussxio oftn h el ateasdtv anceisn m oleculaanrd c ellulbairo logiynt hec onteoxft neuroanatomy • Coveragoef t heb asisct ructuarnedf unctioofnt heb raisnp,i naclo rda,n dp eriphenrearvle sa s ell clinailp ree ntatioofnd ie ae p rocee invoiln gp ei fitcr ucture w a • ClinicCaolr relatiaonndcs a ses tuditesoh elypo ui nterparnedrt e membee re ntia! neuroanatocmoinec p tisn t ermo ff unctiaonnd liniacpaplli catni o • CLINICCOARLR EL..A TIONS CliniCcoarlr elahteiloypno sul earn � � ......... . (W-.-...-�Iftor...... .,..._..,.......cM.. ,_....., neuroanatcoomnicce pitnts h ec ontext .."��.... ..,... ........... .. �....- ..��..�aft ..,.� ..--..-tltf....ft..loc.aflf..• ••M.� �.. ....... ofr eawlo rledx amples ...., ..,.� tt��Mc-1 ft\C!Nic.l ... .,..... ................ ..j........,.. ......... ......... ................. .f.. ...,.._..� ....... .................... o..�--..-............ . ................................... ..,.� COIII ............ �Aft ....""..,".. ...,...... ... e.o �--ctw� 1�·..�..�..-._ � ..·...�·fL- ...,.. ---------�----------------------------------------------------� ·�lfld.....,.....,.. .� ........ IIINICONIIIMI f)-..14 ..... .._ • ....,. ........... ,...,..�� .... ... .. .. - ......... .......... 6M�m;� ---..ldl..�..- ......... ........ ....�.. .Eho", _....... -- LIM., (.,..._ _.. .... 'Wnr ..tn. ....., • IMpt•t � �titM"t tfnr5 • .....wrM '*"'-�4no�"'-ol11-·�..,1cft*�, n�..,· _'..·,.,.�.,.�.... ,_.of ....,.�n-._.._.q-. ...-..,.t.hc�,. ..,.......of....��..,· ..,_.-,.._f'l'_, ' _,. . - ._ -- IIUf'l'ly ��-- trMik.&ul � Ute ...... hf'l t'f'dd.lt �( "*"" (OIIfiJuut ... ..._._--..-....___..._, tr-tnl T,.l.. ..IrIT1w artc:ry ....,t hewt.�..cod o.w. " ·_,-_--1.:: t�w- ttlvdc ... thck-lhh« ........ CMMI.tko ......rl.fW . --.....M..WwpM•h.. .. TI..nu.Ot'_. .., ,.rtc1"Jl �..._.kftt..!-�.._.iD·Ja. .FI- IJ..•.,., .. ..,"..nkn.. �dw .l ...•n. .N-n .....M"...oad! pscto ..f..,.t ..h..Wo..o .._rlddw Wi.. t_.h--r"' itn..h ._Bo�ro Clllndrw btWtJ.-dtU..GR..E.,1OIOi-6i h .......nld ..•..ltlt..�-...el . ........ ...,m�. ft�FS PNI..I�G..NolU..A A.EC L�O CDI6nervn.�RII.-DlfiO-.-1O iflmbtJI- R•COUrwlttlC .,. ..U'GILA.,.TIn..I,...O....N...,. �.... ....... .-...._. . � lcp.Alt- l"".."__,.�.." �lU..U't-- ...--.-.o� -.n.ul �ew-\diM•.. n ..:.a.wrya..' ....'-'..""._ �..,..llk&.:- ..--... ..,_,J..�..cn.L..,.W'I.. . calItli...�l'..d.q.\ftw..--..ttCI ....I"'..c.,_...... ..,..._,......_,.. ...,.� •""..�.. ,...._"".-...._�l _,..uc-- ..__,._..W1idl.·...,,..dw load,.. �wa ..pba"Wio �ibtft.. -.tn. . ..�.. ..'br'NP Ea&•k.Rqdlir .-I•.4wlPfJUdhdol�orHU. lf� -n.-N� ��,E� �R,.cr.V,.....aO.U � SprnoJ.S YS)Tr ...-.E.IUI..MuII.., IIUJia....-..­... -"!' U�-...on •�tw---..-- ��.wlfig� tul�.tlhaor._...pwt:a.\\ � (IW u1t__.A,1h..rt.Jr..e,w: _ri.,�,1u.vm16otnwdct4 rbyt 1tdMlhc-� ..•Mlritc(..tlmc-�.1nol -C -.h'f'U..t.. UIp.�h )o-t olIIr«Jofd. .f'Wt"d..noJI �.-..,_�.._ ..,. kfn-n��cla nl --.-1ocr dtcodl.n ll ..ln'W I.-Mknukh'--.m.•dM-,..tl..n_.., In n �ndtcsto.newW-'d1n �..hrMdws..ol 'lbr...,. '�- r*ll._.-,.*bwll '«..,. •• ..,. W\iul 4;tht --....-•--�n.--....� -._,-.•�-.,.dwft'� *-Ciet--..uawtn..·-rrt-.,.,_...�.. �..d� ..*.,.�...c'w�-..t� .. ""�.t..'- 11IDc...ZIOtcftWI"'*"..r-*_._. ... "Il"..,.w-..... tr"Xtlaf-r_, w. ...-.t_.�.. _.wtMdl....alrd.......__, ...,. f'C.·..tlw..�.._kt--.. .... tt...tr-1-'*-....(...bclt.-�.r..· ....A.,. lhq­......�..).dln...h_. .-..,.'1"._ �-.a ..­.,.,ll -wlc,.t1G-­ ­_. c�•ncnon.MI"WdulbOfti.nwP LA l�� ..N ..�pon'l I..Eaf....�n�..Sk..X.. � .. MAnd.. ..-.....-.a.Ndwkf.w.._lc:fkm.l-..-tD -( lknTEJIM dlcw �tcJ-.S �\.,. f .hrnllwol-com aotrfllIndcq!croirr "ftttnu� l'� or-.dC"'..'ll llriKtUItro.._.,.,.P... ltf"W'G.DJ lp"Uupt.iibm (W.oi..W\ .e.w kmlcf""Yrt1 of -l.'�"'flancI)-"nn v(..Il b. a k .. Development �,.,, �lot ....ol..t twtw. _..,......CCIN talftlii'Cffl..._\bcr-rf'C".tl"lln .a..a-..ortttt..,.. TbtfUnn n...-.w..u..nfll ,..fiorr,.an-•�*""-.,.. ol t«.Unft ....t •.tn! lA IWW�.., .uc-�n ......._. ....frt.l.. l*..•-- �--.�tl_.--.thatol ..lf'Pft' ..•._ ...tt..-...a. .l F ..t-••IT.tokl -2- ..thr .,_.canf,..-rw-� ..................... ... ..aw.:- ·�-.... ��h lllw.n. o.... .. nw-......n.: ._..� .. •�r.\...._, .... o. ......... ilnl; .... ..�......ho. tl..,..._.....,.,.. ... ..,... Tableensc apsulate ---ttana--.t· •-uU�M ..•an•.•,.ltrl ..l�., lll t �,•.. ..I ._,...._ a.·.-.. ---.........��.�..�� _ ... importainntf ormation .,llw�.,_.w flldlc.rn......•..'!..,--._h,co.,... ,.,_..... .. ....."C'\f.la ....'.....,. ..._._.,..,p,.."'- W...,.-.U.._"' ­ �- ca..-----....... .,...,..,.,.,......,.... Ol.kn.,•_.•.u �• 1"lriomrtR .... ,. ... "'-" ....... ....,.., ..•._,- ,..,...�..,.,..�,.._ ... ..,..hj'lf....,crl.......rl-. ll<l ......l ....,....,..,. ..- .....�......, ,..,.,ttf......t tw...,......,..tn. .�.�� ..� .,., ...�,. . .. .-..-,.. .Oil.:.,. ....... ...,._._... .. .... ... �....._... .-.1 U.. UlloM reddo dwcorm't Wir'' .._. ...,...., .... ., ..,__ ..... � ...................... ,. ...... .... � � ....... ....... ., Numeroucso mputetdo mograph(yC T)a ndm agnetirce sonanciem age(sM Riso}f t hen ormablr ain and pinaclo rdfu;n ctionalm agnetrieoc n anciem aget haptr oviad neo runivvawe i ndoown b rain • functiaonndn· e uroimagtiundgi teh aitl ltur actoem monp athloogiclae ntittiheaa tf fetchte nervosuy steimn cludtirnogk ien tracerheebmroarlr haagnedr umoro ft heb raiann dp inaclo rd IntroducttioCo lni nicTahli nkinegcr ione plaihno wt ou neuroanatao myba a i foarn alyzing e thed io rderneedr vosuy etm • Numeroutsa bletsh amta kei nformadt iaoran n de ay tore member • A complete practicteo t eexsyatom u krn owledge • NumeroCusTa ndM RI imageisl lustrate patholoegnitciatli es ..........,Ct ,..,� -. ......,...,._,...,..,..,....,� ...._., p.,.. •• ,� Nih _.-. fill'� nw....,.,.. ............ ,.._.,...tH _...,.,....., �A-G""""'U-.£ A6-15 � .............�. �-�- tll _....,. .. .........,,_.lllo _. c...,.- ..._..,.,_,_ FtGUH6-14� ......... ....,.., • .,.._,_ __ ,_.., ..... -"��filfllll .... �•ltw""""-'......,.•"l"'•lo�t;hllf1'wo �'*""""'-. ....... ., .. ......... ... lhftt\'t'It•W;U.AI)Cll�(6fJ!(.allhiW.{.I6ti-;"f(-r . ..., ..... "'-., .tii"J" "* .......... .tned. .w ... dw�-r-rrn.�r tr� ,�_,.._,�J) MogntRUtcs ononctlrNglng (MR)I M.JII"d ltJCMl"t....JUI...,JIIMfllhM hemiiM'IIL�··th lloiiJiftll -�l}tc 300f+ul l-coillolru strations illumitnhaett eext Thipsa gien tentlieboftln aanlkl y Contents Prefaxic e SECT ION I SECT ION II BASICP RINCIPLES1 INTRODUCTIONT O CLINICAL THINKING 33 1.F undamentoaflt sh eN ervouSsy stem1 GenerPallao nft hNee rvoSuyss te1m 4. TheR elationBsehtiwp eeNne uroanatomy PeriphNeerravloS uyss te5m andN eurolog3y3 PlanaensdT erms 5 SymptoamnsdS igonfsN eurolDoigsieca s3e3s Referen6c es Wheriest hlee sio3n6? 2. DevelopmeanntdC ellulCaorn stituents Whaits t hlee sio3n8? oft heN ervouSsy stem7 CliniIclallu st4r-1at 3i9o n CelluAlsapre ocftN se urDaelv elopm7e nt CliniIcllauls tr4a-ti23o 9n Neuron7s TheR oloef NeuroimaangdLi anbgo ratory NeuronGarlo upianngdCs o nnecti1o1n s Investig3a9t ions Neurogl1i1a TheT reatmoefPn att iewnittNshe urologic DegeneraantdRi eogne nera1t5i on Disea40s e Neurogen1e7s is CliniIclallu st4r-at340i on Referen1c8e s CliniIcllauls tr4a-ti440o n CliniIcllauls tr4a-ti54o 1n 3. Signaliinnt gh eN ervouSsy stem1 9 Referen4c1e s MembraPnoet ent1i9a l GeneraPtootre nt2i0a ls ActiPoont ent2i0al s SECT ION Ill ThNee rvCee lMle mbraCnoen tains IoCnh anne2l1s SPINALC ORD AND SPINE 43 TheE ffeocfMt yse linat2i2o n ConductoifAo cnt iPoont ent2i3a ls 5. TheS pinaClo rd 43 Synapses Developm4e3n t 24 CliniIclallu st3r-at1i on ExterAnnaalt oomfty h Sep inCaolr d4 3 24 SynapTtriacn smis2s6i on Spinal aRnodNo etrsv e46s ExcitaatnodIr nyh ibiStyonraypA tcitci o2n7s InterDniavli soifot nhSsep inCaolr d48 SynapPtliacs taincdLi otnyTg e-rm Potentiation Pa2t7h wianyW sh itMea tte5r0 PresynIanphtiibci t2i8o n CliniIclallu st5r-at15i 5o n ThNee uromuscJuulnacrta inodn Reflexe5s6 thEen d-PlPaotteen t2i8a l Lesiionnt shM eo toPra thwa60y s Neurotransm2i9t ters ExampolfeS sp eciSfipci nCaolr Ddi sord6e3r s Cas1e 31 Cas2e 64 Referen3c2e s Cas3e 64 Referen6c5e s vii viii Contents 6. TheV ertebCroallu mna ndO theSrt ructures CliniIclallu st1ra0t-i11o4 n0 SurroundtihnegS pinaClo rd 67 PhysioolfSo pgeyc ialized Cor1t4i2c al Regions InvesMteimnbgr an6e7s BasGaaln gli1a4 3 SpinCaolrC di rcula6t8i on InterCnaapls ul1e4 4 TheV erteCborlaulm n6 9 Cas1e 11 47 CliniIcllauls tr6a-ti16o 9n Cas1e2 1 47 CliniIclallu st6r-at27i 1o n Referen1c4e7s LumbaPru nctu7r1e 11.V entricalnedCs o verinogfts h eB rain1 49 Imagionftg h Sep ianned S pinCaolr d7 3 VentriScyusltaer1m 4 9 Cas4e 73 MeninagnedsS ubmeninSgpeaacle1 s5 0 Cas5e 74 CSF 152 Referen7c7e s Barriientr hsNe e rvoSuyss te1m5 4 Skul1l5 6 Cas1e3 1 60 sEcT I 0 INV Cas1e4 1 61 Referen1c6e2s ANATOMY OF THE BRAIN 79 12.V asculSaurp ployft heB rain1 63 7. TheB rain SatnedmC erebellu7m9 ArterSiuaplpol fty h Ber ai1n6 3 Developomfte nhBter aSitne m VenoDursa ina1g6e5 andC ranNiearlv e7s9 CerebrovaDsicsuolradr1e 6r9s BraSitne Omr ganization 79 CliniIclallu st1r-a2t1i1 o7n5 CranialN uNcelrievntie h Ber aSitne m8 2 Cas1e5 1 77 Medulla8 2 Cas1e6 1 78 Pons8 7 Referen1c8e1s Midbra8i8n Vasculari8z9a tion CliniIclallu st7r-at19i 0o n SECT ION v Cerebel9l1u m CliniIclallu st7r-at29i 2o n FUNCTIONALS YSTEMS 183 ClinIillcauls tr7a-ti39o 2n CliniIclallu st7r-at49i 6o n 13.C ontrooflM ovement1 83 Cas6e 98 ControofMl o vemen1t8 3 Cas7e 98 MajoMro toSry stem1s8 3 Referen9c8e s MotoDri sturba1n8c9e s Cas1e7 1 93 8. Cranial Nerves and 9P9a thways Cas1e8 1 94 OrigoifCn r anial FNiebrevr9es9 Referen1c9e4s FunctiCoonmaplo neonftt hsCe r anNiearlv e9s9 Anatomic Reloaftt ihCoern asnhNiieaprlsv e1s0 2 14.S omatosensSoyrsyt ems1 95 Cas8e 116 Recept1o9r5s Cas9e 116 Connecti1o9n5s Referen1c1e8s SensoPrayt hwa1y9s5 CortiAcraela s1 96 9. Diencephal1o1n9 Pain1 96 Thalam1u1s9 Cas1e9 1 99 Hypothala1m2u1s Cas2e0 2 00 Subthala1m2u6s Referen2c0e0s Epithala1m2u7s CircumventOrrigcaun1ls2a r8 15.T heV isuaSly stem2 01 Cas1e0 1 29 TheE ye2 01 References 129 VisuPaalt hwa2y0s5 TheV isuCaolr te2x0 9 10.C erebrHaelm ispheres/Telence1p3h1a lon CliniIcllauls t1ra5t-i21o1 n0 Developm1e3n1t Cas2e1 2 14 Anatoomfyt hCee rebHreamli sphe1r3e1s Referen2c1e4s MicroscSotpriucco tftu hrCeeo rte1x3 6 Contentixs 16.T heA uditoSryys tem2 15 sEcT I 0 VN I AnatoamnydF uncti2o1n5 AuditPoartyh wa2y1s5 DIAGNOSTIC AIDS 267 Cas2e2 2 18 Referen2c1e9s 22.I maginogft heB rain 267 SkuXl-lR aFyi lm2s6 7 17.T heV estibuSlyasrt em2 21 Angiogra2p6h7y Anatom2y2 1 ComputTeodm ograp2h6y8 VestibPualtahrw a2y2s1 MagneRteisco naInmcaeg in2g7 0 Functio2n2s1 MagneRteisco naSnpceec tros2c7o3p y Cas2e3 2 24 Diffusion-WIemigahgtien2dg7 3 Referen2c2e4s FunctiMoRnIa 2l7 4 18.T heR eticuFloarrm atio2n2 5 PositErmoins sTioomno grap2h7y5 Anatom2y2 5 SingPlheo tEomni ssCiTo n2 76 Functio2n2s5 Referen2c7e6s Referen2c2e8s 23.E lectrodiagTneossttsi2 c7 7 19.T heL imbiScy stem2 29 Electroenceph2a7l7o graphy TheL imbLiocb aen dL imbSiycs te2m2 9 EvokPeodt ent2i7a8ls OlfacStyosrtye 2m2 9 TranscrMaontioCarol r tiSctailm ula2t8i0o n HippocaFmopramla ti2o3n0 Electromyog2r8a0p hy CliniIclallu st1r-a9t1i2 o3n2 NervCeo nductSitound i2e8s3 FunctiaonndDs i sord2e3r6s Referen2c8e4s SeptAarle a2 36 Cas2e4 2 39 24.C erebrospFilnuailEd x aminatio2n8 5 Indicat2i8o5n s References 239 Contraindi2c8a5t ions 20.T heA utonomNiecr vouSsy stem2 41 Analyosfti hsCe S F 285 AutonoOmuitcfl ow2 41 Refere2n8c6e AutonoImnince rvoaftt ihoHene ad2 47 VisceArffaelr ePnatt hwa248y s HierarcOhrigcaanli zoaftt hiAeou nt onomic sEcT I 0 VN II NervoSuyss te2m4 9 TransmiStutbesrt an2c5e1s DISCUSSIOONF CASES 287 Cas2e5 2 55 References 255 25.D iscussoifoC na ses2 87 TheL ocatoifLo ens io2n8s7 21.H igheCro rticFauln ction2s5 7 ThNea tuorfeL esio2n8s8 FronLtoablFe u nctio2n5s7 Case2s8 9 LanguaangdeS p eec2h5 7 Referen3c0e3s CerebDroamli nan2c6e2 Memorayn dL earni2n6g2 Epilep2s6y2 AppendixA :T heN eurologic Exami3na0t5i on ClinicIalllu st2r1at-i21o6 n4 Cas2e6 2 65 AppendixB :T estinMgu sclFeu nctio3n1 3 Cas2e7 2 66 AppendixC :S pinaNle rveasn dP lexuse3s2 9 Referen2c6e6s AppendixD :Q uestioannsdA nswers3 47 Inde3x 55