BOOK
Bradley's Neurology in Clinical Practice E-Book
Robert B. Daroff | Joseph Jankovic | John C Mazziotta | Scott L Pomeroy
(2015)
Additional Information
Book Details
Abstract
Comprehensive, easy to read, and clinically relevant, Bradley’s Neurology in Clinical Practice provides the most up-to-date information presented by a veritable "Who's Who" of clinical neuroscience. Its unique organization allows users to access content both by presenting symptom/sign and by specific disease entities—mirroring the way neurologists practice. A practical, straightforward style; templated organization; evidence-based references; and robust interactive content combine to make this an ideal, dynamic resource for both practicing neurologists and trainees.
- Authoritative, up-to-date guidance from Drs. Daroff, Jankovic, Mazziotta, and Pomeroy along with more than 150 expert contributors equips you to effectively diagnose and manage the full range of neurological disorders.
- Easy searches through an intuitive organization by both symptom and grouping of diseases mirrors the way you practice.
- The latest advances in clinical neurogenetics, brain perfusion techniques for cerebrovascular disease, the relationship between neurotrauma and neurodegenerative disease, management strategies for levodopa-related complications in movement disorders, progressive neuropsychiatric disorders arising from autoimmune encephalitis, and more keep you at the forefront of your field.
- Reorganized table of contents which includes new chapters on: Brain Death, Vegetative, and Minimally Conscious States; Deep Brain Stimulation; Sexual Dysfunction in Degenerative and Spinal Cord Disorders; Sports and Performance Concussion; Effects of Drug Abuse on the Nervous System; and Mechanisms of Neurodegenerative Disorders.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| 9780323339162v1_WEB | 1 | ||
| Front Cover | 1 | ||
| Half title page | 2 | ||
| Dedication | 3 | ||
| Bradley’s Neurology in Clinical Practice | 4 | ||
| Copyright Page | 5 | ||
| Table Of Contents | 6 | ||
| Foreword | 10 | ||
| Preface | 11 | ||
| List of Contributors | 12 | ||
| Video Table of Contents | 19 | ||
| I Common Neurological Problems | 24 | ||
| 1 Diagnosis of Neurological Disease | 24 | ||
| Chapter Outline | 24 | ||
| Neurological Interview | 24 | ||
| Chief Complaint | 25 | ||
| History of Present Illness | 25 | ||
| Review of Patient-Specific Information | 26 | ||
| Review of Systems | 26 | ||
| History of Previous Illnesses | 26 | ||
| Family History | 27 | ||
| Social History | 27 | ||
| Examination | 27 | ||
| Neurological Examination | 27 | ||
| General Physical Examination | 28 | ||
| Assessment of the Cause of the Patient’s Symptoms | 28 | ||
| Anatomical Localization | 28 | ||
| Differential Diagnosis | 29 | ||
| Laboratory Investigations | 29 | ||
| Management of Neurological Disorders | 30 | ||
| Experienced Neurologist’s Approach to the Diagnosis of Common Neurological Problems | 30 | ||
| 2 Episodic Impairment of Consciousness | 31 | ||
| Chapter Outline | 31 | ||
| Syncope | 31 | ||
| History and Physical Examination | 31 | ||
| Causes of Syncope | 33 | ||
| Cardiac Arrhythmias | 33 | ||
| Atrioventricular Block | 33 | ||
| Sinoatrial Block | 33 | ||
| Paroxysmal Tachycardia | 33 | ||
| Reflex Cardiac Arrhythmias | 34 | ||
| Decreased Cardiac Output | 34 | ||
| Hypovolemia | 34 | ||
| Hypotension | 34 | ||
| Cerebrovascular Ischemia | 35 | ||
| Metabolic Disorders | 35 | ||
| Miscellaneous Causes of Syncope | 35 | ||
| Investigations of Patients with Syncope | 36 | ||
| Seizures | 36 | ||
| History and Physical Examination | 36 | ||
| Absence Seizures | 37 | ||
| Tonic-Clonic Seizures | 37 | ||
| Complex Partial Seizures | 37 | ||
| Investigations of Seizures | 37 | ||
| Psychogenic (Nonepileptic) Seizures | 38 | ||
| Miscellaneous Causes of Altered Consciousness | 38 | ||
| References | 39 | ||
| References | 40 | ||
| 3 Falls and Drop Attacks | 41 | ||
| Chapter Outline | 41 | ||
| Drop Attacks with Loss of Consciousness | 41 | ||
| Syncope | 41 | ||
| Seizures | 42 | ||
| Drop Attacks without Loss of Consciousness | 42 | ||
| Transient Ischemic Attacks | 42 | ||
| Vertebrobasilar Insufficiency | 42 | ||
| Anterior Cerebral Artery Ischemia | 42 | ||
| Third Ventricular and Posterior Fossa Abnormalities | 42 | ||
| Otolith Crisis | 43 | ||
| Falls | 43 | ||
| Neuromuscular Disorders and Myelopathy | 43 | ||
| Stroke | 43 | ||
| Other Cerebral or Cerebellar Disorders | 43 | ||
| Cryptogenic Falls in the Middle-Aged | 43 | ||
| Aging, Neurodegeneration, and the Neural Substrate of Gait and Balance | 44 | ||
| Basal Ganglia Disorders | 44 | ||
| Parkinson Disease. | 44 | ||
| Progressive Supranuclear Palsy and other Parkinsonian Syndromes. | 44 | ||
| Aged State | 44 | ||
| Summary | 46 | ||
| References | 46 | ||
| References | 47 | ||
| 4 Delirium | 49 | ||
| Chapter Outline | 49 | ||
| Clinical Characteristics | 49 | ||
| Acute Onset with Fluctuating Course | 49 | ||
| Cognitive and Related Abnormalities | 50 | ||
| Attentional Deficits | 50 | ||
| Confusion or Disorganized Thinking | 51 | ||
| Altered Level of Consciousness | 51 | ||
| Perceptual Disturbances | 51 | ||
| Disturbed Sleep/Wake Cycle | 51 | ||
| Altered Psychomotor Activity | 51 | ||
| Disorientation and Memory Impairment | 52 | ||
| Other Cognitive Deficits | 52 | ||
| Behavioral and Emotional Abnormalities | 52 | ||
| Pathophysiology | 52 | ||
| Diagnosis | 53 | ||
| Predisposing and Precipitating Factors | 53 | ||
| Mental Status Examination | 54 | ||
| Diagnostic Scales and Criteria | 54 | ||
| Physical Examination | 55 | ||
| Laboratory Tests | 55 | ||
| Differential Diagnosis | 55 | ||
| Common Causes of Delirium | 55 | ||
| Metabolic Disturbances | 55 | ||
| Drugs | 56 | ||
| Infections | 56 | ||
| Strokes | 56 | ||
| Epilepsy | 57 | ||
| Postoperative Causes | 57 | ||
| Other Neurological Causes | 57 | ||
| Miscellaneous Causes | 57 | ||
| Special Problems in Differential Diagnosis | 57 | ||
| Prevention and Management | 58 | ||
| Prognosis | 59 | ||
| References | 59 | ||
| References | 60 | ||
| 5 Stupor and Coma | 62 | ||
| Chapter Outline | 62 | ||
| Definitions | 62 | ||
| Conditions That May Mimic Coma | 62 | ||
| Approach to the Patient in Coma | 63 | ||
| Rapid Initial Examination and Emergency Therapy | 63 | ||
| Common Presentations | 65 | ||
| History | 65 | ||
| General Examination | 66 | ||
| Blood Pressure Evaluation | 66 | ||
| Hypotension. | 66 | ||
| Hypertension. | 66 | ||
| Heart Rate | 66 | ||
| Respiration | 66 | ||
| Temperature | 66 | ||
| General Appearance | 66 | ||
| Head and Neck Examination | 67 | ||
| Eye Examination | 67 | ||
| Otoscopic Examination | 67 | ||
| Oral Examination | 67 | ||
| Integument Examination | 67 | ||
| Examination of Lymph Nodes | 67 | ||
| Cardiac Examination | 67 | ||
| Abdominal Examination | 67 | ||
| Miscellaneous Examinations | 67 | ||
| Neurological Examination | 68 | ||
| State of Consciousness | 68 | ||
| Respiration | 69 | ||
| Pupil Size and Reactivity | 70 | ||
| Ocular Motility | 71 | ||
| Abnormalities in Resting Position. | 72 | ||
| Eye Deviation. | 72 | ||
| Spontaneous Eye Movements. | 72 | ||
| Reflex Ocular Movements. | 72 | ||
| Motor System | 73 | ||
| Coma and Brain Herniation | 74 | ||
| Differential Diagnosis | 75 | ||
| Differentiating Toxic-Metabolic Coma from Structural Coma | 75 | ||
| Differentiating Psychiatric Coma and Pseudocoma from Metabolic or Structural Coma | 75 | ||
| Helpful Laboratory Studies | 76 | ||
| Other Useful Studies | 76 | ||
| Electrocardiography | 76 | ||
| Neuroradiological Imaging | 76 | ||
| Electroencephalography | 76 | ||
| Evoked Potentials | 77 | ||
| Intracranial Pressure Monitoring | 77 | ||
| Prognosis | 78 | ||
| Nontraumatic Coma | 78 | ||
| Traumatic Coma | 78 | ||
| Persistent Vegetative State | 78 | ||
| Brain Death | 78 | ||
| References | 78 | ||
| References | 79 | ||
| 6 Brain Death, Vegetative State, and Minimally Conscious States | 80 | ||
| Chapter Outline | 80 | ||
| Brain Death | 80 | ||
| Prolonged Disorders of Consciousness | 83 | ||
| Vegetative State | 83 | ||
| Minimally Conscious State | 83 | ||
| Imaging in Disorders of Consciousness | 84 | ||
| Decision-making and bioethics | 85 | ||
| References | 85 | ||
| References | 86 | ||
| 7 Intellectual and Memory Impairments | 87 | ||
| Chapter Outline | 87 | ||
| Neural Basis of Cognition | 87 | ||
| Cerebral Cortex | 87 | ||
| Consciousness | 88 | ||
| Memory | 90 | ||
| Forms and Stages of Declarative Memory | 90 | ||
| Formation and Retrieval of Episodic Memories | 91 | ||
| Amnestic Syndrome | 91 | ||
| Syndromes of Partial Memory Loss | 93 | ||
| Transient Amnesia | 93 | ||
| Other Types of Memory (Nondeclarative or Implicit Memory) | 93 | ||
| Bedside Tests of Memory and Cognitive Function | 94 | ||
| References | 95 | ||
| References | 96 | ||
| 8 Global Developmental Delay and Regression | 98 | ||
| Chapter Outline | 98 | ||
| Typical and Atypical Development | 98 | ||
| Child Development Concepts | 98 | ||
| Global Developmental Delay | 98 | ||
| Developmental History | 98 | ||
| Neurological and Other Medical History | 98 | ||
| Physical Examination | 99 | ||
| Diagnostic Testing | 99 | ||
| Genetic Testing | 100 | ||
| Neuroimaging | 101 | ||
| Other Tests | 101 | ||
| Management | 103 | ||
| Prognosis | 103 | ||
| Recurrence Risk | 103 | ||
| Regression | 104 | ||
| References | 104 | ||
| References | 105 | ||
| 9 Behavior and Personality Disturbances | 106 | ||
| Chapter Outline | 106 | ||
| Frontosubcortical Circuitry | 106 | ||
| Assessing Behavior and Personality Disturbances in Patients with Cerebral Dysfunction | 108 | ||
| Classification of Neurobehavioral Symptoms and Disorders | 109 | ||
| Assessment of Depression | 109 | ||
| Assessment of Other Behavioral and Personality Disturbances | 109 | ||
| Behavior and Personality Disturbances Associated with Cerebral Dysfunction | 110 | ||
| Alzheimer Disease | 110 | ||
| Depression | 111 | ||
| Apathy | 111 | ||
| Aggression | 111 | ||
| Psychosis | 111 | ||
| Frontotemporal Dementia | 112 | ||
| Behavioral Disruption | 112 | ||
| Anosognosia | 112 | ||
| Relationship to Anatomy | 113 | ||
| Vascular Dementia | 113 | ||
| Depression | 113 | ||
| Additional Behavioral and Psychiatric Disorders | 113 | ||
| Parkinson Disease | 113 | ||
| Depression | 114 | ||
| Psychosis | 114 | ||
| Apathy | 114 | ||
| Impulse Control Disorders | 114 | ||
| Neuropsychiatric Effects of Deep Brain Stimulation | 114 | ||
| Dementia with Lewy Bodies | 115 | ||
| Psychosis | 115 | ||
| Huntington Disease | 115 | ||
| Depression | 115 | ||
| Suicide | 120 | ||
| Psychosis | 120 | ||
| Obsessive-Compulsive Traits | 120 | ||
| Aggression | 120 | ||
| Apathy | 120 | ||
| Tourette Syndrome | 120 | ||
| Multiple Sclerosis | 120 | ||
| Depression | 120 | ||
| Anxiety | 121 | ||
| Euphoria | 121 | ||
| Pseudobulbar Affect | 121 | ||
| Amyotrophic Lateral Sclerosis | 122 | ||
| Depression | 122 | ||
| Pseudobulbar Affect | 122 | ||
| Personality Change | 122 | ||
| Epilepsy | 123 | ||
| Depression | 125 | ||
| Anxiety | 125 | ||
| Psychosis | 125 | ||
| Aggression | 126 | ||
| Stroke | 126 | ||
| Depression | 126 | ||
| Pseudobulbar Affect | 127 | ||
| Aggression | 127 | ||
| Psychosis | 127 | ||
| Traumatic Brain Injury | 127 | ||
| Anosognosia | 127 | ||
| Depression | 127 | ||
| Anxiety | 128 | ||
| Apathy | 128 | ||
| Personality Change | 128 | ||
| References | 128 | ||
| References | 129 | ||
| 10 Depression and Psychosis in Neurological Practice | 133 | ||
| Chapter Outline | 133 | ||
| Principles of Differential Diagnosis | 133 | ||
| Principles of Neuropsychiatric Evaluation | 135 | ||
| Cognitive-Affective-Behavioral Brain Behavior Relationships | 136 | ||
| Cortical Networks | 136 | ||
| Frontosubcortical Networks | 138 | ||
| Cerebrocerebellar Networks | 139 | ||
| Biology of Psychosis | 139 | ||
| Biology of Depression | 140 | ||
| Clinical Symptoms and Signs Suggesting Neurological Disease | 141 | ||
| Psychiatric Manifestations of Neurological Disease | 141 | ||
| Stroke and Cerebral Vascular Disease | 141 | ||
| Infectious | 145 | ||
| Human Immunodeficiency Virus | 145 | ||
| Creutzfeldt–Jakob Disease | 145 | ||
| Neurosyphilis | 146 | ||
| Metabolic and Toxic | 146 | ||
| Thyroid Disease | 146 | ||
| Wilson Disease | 148 | ||
| Vitamin B12 and Folic Acid Deficiency | 148 | ||
| Porphyrias | 148 | ||
| Drug Abuse | 149 | ||
| Systemic Lupus Erythematosus | 149 | ||
| Multiple Sclerosis | 149 | ||
| Neoplastic | 151 | ||
| Degenerative | 151 | ||
| Alzheimer Disease and Mild Cognitive Impairment | 152 | ||
| Frontotemporal Dementia | 152 | ||
| Idiopathic Parkinson Disease | 153 | ||
| Dementia with Lewy Bodies | 153 | ||
| Huntington Disease | 153 | ||
| Epilepsy | 153 | ||
| Traumatic Brain Injury | 155 | ||
| Depression-Related Cognitive Impairment | 156 | ||
| Delirium | 156 | ||
| Catatonia | 157 | ||
| Treatment Modalities | 157 | ||
| Electroconvulsive Therapy | 160 | ||
| Vagus Nerve Stimulation | 160 | ||
| Repetitive Transcranial Magnetic Stimulation | 160 | ||
| Psychiatric Neurosurgery or Psychosurgery | 160 | ||
| Treatment Principles | 161 | ||
| References | 161 | ||
| References | 162 | ||
| 11 Limb Apraxias and Related Disorders | 166 | ||
| Chapter Outline | 166 | ||
| Historical Perspective | 166 | ||
| A Model for Praxis | 167 | ||
| Classification of Limb Apraxias | 167 | ||
| Ideomotor Apraxia, Parietal Variant | 168 | ||
| Ideomotor Apraxia, Disconnection Variant | 168 | ||
| Dissociation Apraxia | 168 | ||
| Ideational Apraxia | 168 | ||
| Conceptual Apraxia | 168 | ||
| Limb-Kinetic Apraxia | 168 | ||
| Callosal Apraxia | 169 | ||
| Testing for Limb Apraxias | 169 | ||
| Testing for Ideomotor Apraxia, Parietal and Disconnection Variants | 170 | ||
| Testing for Dissociation Apraxia | 170 | ||
| Testing for Ideational Apraxia | 171 | ||
| Testing for Conceptual Apraxia | 171 | ||
| Testing for Limb-Kinetic Apraxia | 171 | ||
| Testing for Callosal Apraxia | 171 | ||
| Pathophysiology of Limb Apraxias | 171 | ||
| Rehabilitation for Limb Apraxias | 171 | ||
| Related Disorders | 172 | ||
| Summary | 172 | ||
| References | 172 | ||
| References | 173 | ||
| 12 Agnosias | 174 | ||
| Chapter Outline | 174 | ||
| Visual Agnosias | 174 | ||
| Cortical Visual Disturbances | 174 | ||
| Cortical Visual Distortions | 175 | ||
| Balint Syndrome and Simultanagnosia | 175 | ||
| Visual Object Agnosia | 175 | ||
| Apperceptive Visual Agnosia | 175 | ||
| Associative Visual Agnosia | 176 | ||
| Optic Aphasia | 176 | ||
| Prosopagnosia | 177 | ||
| Klüver–Bucy Syndrome | 177 | ||
| Auditory Agnosias | 177 | ||
| Cortical Deafness | 177 | ||
| Pure Word Deafness | 178 | ||
| Auditory Nonverbal Agnosia | 178 | ||
| Phonagnosia | 178 | ||
| Amusia | 178 | ||
| Tactile Agnosias | 179 | ||
| Tactile Aphasia | 179 | ||
| Summary | 179 | ||
| Acknowledgment | 179 | ||
| References | 179 | ||
| References | 180 | ||
| 13 Aphasia and Aphasic Syndromes | 181 | ||
| Chapter Outline | 181 | ||
| Symptoms and Differential Diagnosis of Disordered Language | 183 | ||
| Bedside Language Examination | 183 | ||
| Differential Diagnosis of Aphasic Syndromes | 184 | ||
| Broca Aphasia | 184 | ||
| Aphemia | 185 | ||
| Wernicke Aphasia | 185 | ||
| Pure Word Deafness | 186 | ||
| Global Aphasia | 186 | ||
| Conduction Aphasia | 186 | ||
| Anomic Aphasia | 187 | ||
| Transcortical Aphasias | 188 | ||
| Subcortical Aphasias | 189 | ||
| Pure Alexia without Agraphia | 190 | ||
| Alexia with Agraphia | 191 | ||
| Aphasic Alexia | 191 | ||
| Agraphia | 192 | ||
| Language in Right Hemisphere Disorders | 192 | ||
| Language in Dementing Diseases | 193 | ||
| Investigation of the Aphasic Patient | 194 | ||
| Clinical Tests | 194 | ||
| Differential Diagnosis | 194 | ||
| Recovery and Rehabilitation of Aphasia | 196 | ||
| References | 197 | ||
| References | 198 | ||
| 14 Dysarthria and Apraxia of Speech | 200 | ||
| Chapter Outline | 200 | ||
| Motor Speech Disorders | 200 | ||
| Dysarthrias | 200 | ||
| Apraxia of Speech | 201 | ||
| Oral or Buccolingual Apraxia | 202 | ||
| Aphemia | 202 | ||
| The “Foreign Accent Syndrome” | 202 | ||
| Acquired Stuttering | 202 | ||
| Opercular Syndrome | 202 | ||
| References | 202 | ||
| References | 203 | ||
| 15 Neurogenic Dysphagia | 204 | ||
| Chapter Outline | 204 | ||
| Normal Swallowing | 204 | ||
| Neurophysiology of Swallowing | 204 | ||
| Mechanical Dysphagia | 205 | ||
| Neuromuscular Dysphagia | 205 | ||
| Oculopharyngeal Muscular Dystrophy | 206 | ||
| Myotonic Dystrophy | 206 | ||
| Other Muscular Dystrophies | 206 | ||
| Inflammatory Myopathies | 206 | ||
| Mitochondrial Disorders | 207 | ||
| Myasthenia Gravis | 207 | ||
| Neurogenic Dysphagia | 207 | ||
| Stroke | 208 | ||
| Multiple Sclerosis | 209 | ||
| Parkinson Disease | 210 | ||
| Other Basal Ganglia Disorders | 210 | ||
| Amyotrophic Lateral Sclerosis | 211 | ||
| Cranial Neuropathies | 211 | ||
| Brainstem Processes | 211 | ||
| Cervical Spinal Cord Injury | 211 | ||
| Other Processes | 212 | ||
| Evaluation of Dysphagia | 212 | ||
| References | 213 | ||
| References | 214 | ||
| 16 Visual Loss | 216 | ||
| Chapter Outline | 216 | ||
| Pattern of Visual Loss | 216 | ||
| Central Visual Loss | 216 | ||
| Peripheral Visual Loss | 216 | ||
| Temporal Profile of Visual Loss | 216 | ||
| Sudden-Onset Visual Loss | 216 | ||
| Transient Monocular Visual Loss | 216 | ||
| Amaurosis Fugax. | 216 | ||
| Retinal Artery Vasospasm. | 216 | ||
| Angle-Closure Glaucoma. | 216 | ||
| Visual Loss in Bright Light. | 217 | ||
| Uhthoff Phenomenon. | 217 | ||
| Transient Visual Obscurations. | 217 | ||
| Other Causes of Transient Visual Loss. | 217 | ||
| Transient Binocular Visual Loss | 217 | ||
| Sudden Monocular Visual Loss without Progression | 217 | ||
| Sudden Binocular Visual Loss without Progression | 219 | ||
| Sudden Visual Loss with Progression | 219 | ||
| Progressive Visual Loss | 219 | ||
| References | 220 | ||
| References | 221 | ||
| 17 Abnormalities of the Optic Nerve and Retina | 222 | ||
| Chapter Outline | 222 | ||
| Optic Nerve Anatomy and Physiology | 222 | ||
| The Swollen Optic Disc | 222 | ||
| Unilateral Optic Disc Swelling | 222 | ||
| Optic Neuritis | 224 | ||
| Ischemic Optic Neuropathy | 225 | ||
| Other Causes | 226 | ||
| Bilateral Optic Disc Swelling | 229 | ||
| Papilledema | 229 | ||
| Malignant Hypertension | 231 | ||
| Diabetic Papillopathy | 231 | ||
| Other Causes | 231 | ||
| Pseudopapilledema | 232 | ||
| Optic Disc Drusen | 232 | ||
| Optic Neuropathies with Normal-Appearing Optic Discs | 233 | ||
| Unilateral Presentations | 233 | ||
| Bilateral Presentations | 233 | ||
| Optic Neuropathies with Optic Atrophy | 233 | ||
| Congenital Optic Disc Anomalies | 234 | ||
| Tilted Optic Disc | 234 | ||
| Optic Nerve Dysplasia | 234 | ||
| Retinal Disorders | 235 | ||
| Retinal Arterial Disease | 235 | ||
| Branch Retinal Artery Occlusions and Encephalopathy (Susac Syndrome) | 236 | ||
| Ocular Ischemic Syndrome | 236 | ||
| Retinal Vein Occlusion | 236 | ||
| Retinal Degenerations | 236 | ||
| Phakomatoses | 237 | ||
| References | 237 | ||
| References | 238 | ||
| 18 Pupillary and Eyelid Abnormalities | 239 | ||
| Chapter Outline | 239 | ||
| Pupillary Abnormalities | 239 | ||
| Pupil Anatomy and Neural Control | 239 | ||
| Normal Pupil Phenomena | 239 | ||
| Afferent Pathological Conditions of the Pupils | 239 | ||
| Efferent Pathological Conditions of the Pupils | 240 | ||
| Clinical Presentation and Examination | 240 | ||
| Anisocoria Greater in the Light | 240 | ||
| Postganglionic Parasympathetic Dysfunction—Tonic Pupil. | 240 | ||
| Preganglionic Parasympathetic Dysfunction—Oculomotor Palsy. | 242 | ||
| Iris Sphincter Injury and Ischemia. | 243 | ||
| Pharmacological Mydriasis. | 243 | ||
| Anisocoria Greater in the Dark | 244 | ||
| Horner Syndrome. | 244 | ||
| Anterior Uveitis (Iris Inflammation). | 245 | ||
| Episodic Anisocoria | 246 | ||
| Pupillary Light-Near Dissociation | 246 | ||
| Eyelid Abnormalities | 246 | ||
| Eyelid Anatomy and Neural Control | 246 | ||
| Pathological Conditions of the Eyelids | 246 | ||
| Clinical Presentation and Examination | 246 | ||
| Pathologically Widened Palpebral Fissures | 247 | ||
| Pathologically Narrowed Palpebral Fissures | 248 | ||
| Dynamic Eyelid Abnormalities | 248 | ||
| References | 249 | ||
| References | 250 | ||
| 19 Disturbances of Smell and Taste | 251 | ||
| Chapter Outline | 251 | ||
| Anatomy and Physiology | 251 | ||
| Olfaction | 251 | ||
| Gustation | 252 | ||
| Chemosensory Testing | 253 | ||
| Disorders of Olfaction | 254 | ||
| Disorders of Taste | 255 | ||
| Clinical Evaluation of Taste and Smell | 256 | ||
| Treatment and Management | 256 | ||
| References | 257 | ||
| References | 258 | ||
| 20 Cranial and Facial Pain | 259 | ||
| Chapter Outline | 259 | ||
| History | 259 | ||
| Types of Headaches | 259 | ||
| Onset of Headaches | 259 | ||
| Frequency and Periodicity of Episodic Headaches | 260 | ||
| Temporal Profile | 260 | ||
| Time of Day and Precipitating Factors | 261 | ||
| Location | 261 | ||
| Quality and Severity | 261 | ||
| Premonitory Symptoms, Aura, and Accompanying Symptoms | 261 | ||
| Aggravating and Mitigating Factors | 262 | ||
| Family History of Headaches | 262 | ||
| Prior Evaluation | 262 | ||
| Prior Treatment | 262 | ||
| Disability | 262 | ||
| Patient Concerns and Reasons for Seeking Help | 262 | ||
| Other Medical or Neurological Problems | 262 | ||
| Examination | 262 | ||
| Diagnostic Testing | 263 | ||
| Neuroimaging and Other Imaging Studies | 263 | ||
| Computed Tomography and Magnetic Resonance Imaging | 263 | ||
| Plain Radiographs and Other Imaging of the Skull, Sinuses, and Cervical Spine | 264 | ||
| Temporomandibular Joint/Dental Imaging Studies | 264 | ||
| Cerebral Angiography | 264 | ||
| Myelography with Computed Tomography and Radioisotope Studies for Detection of Cerebrospinal Fluid Leaks | 264 | ||
| Cerebrospinal Fluid Tests | 264 | ||
| Electrophysiological Testing | 264 | ||
| General Medical Tests | 264 | ||
| Special Examinations and Consultations | 265 | ||
| Further Observation | 266 | ||
| References | 266 | ||
| References | 267 | ||
| 21 Brainstem Syndromes | 268 | ||
| Chapter Outline | 268 | ||
| Ocular Motor Syndromes | 268 | ||
| Combined Vertical Gaze Ophthalmoplegia | 268 | ||
| Upgaze Paresis (Dorsal Midbrain or Parinaud Syndrome) | 269 | ||
| Downgaze Paresis | 269 | ||
| Internuclear Ophthalmoplegia | 270 | ||
| Horizontal Gaze Paresis | 270 | ||
| Global Paralysis of Gaze | 270 | ||
| One-and-a-Half Syndrome | 271 | ||
| Syndromes Involving Ocular Motor Nuclei | 271 | ||
| Third Cranial Nerve Nucleus | 271 | ||
| Sixth Cranial Nerve Nucleus | 271 | ||
| Other Brainstem and Associated Syndromes | 271 | ||
| Diencephalic Syndrome (Russell Syndrome) | 271 | ||
| Thalamic Syndrome | 272 | ||
| Tectal Deafness | 272 | ||
| Foramen Magnum Syndrome | 272 | ||
| Syringobulbia | 272 | ||
| Brainstem Ischemic Stroke Syndromes | 273 | ||
| Thalamic Stroke Syndromes | 273 | ||
| Midbrain Stroke Syndromes | 274 | ||
| Pontine Stroke Syndromes | 275 | ||
| Medullary Stroke Syndromes | 275 | ||
| References | 279 | ||
| References | 280 | ||
| 22 Ataxic and Cerebellar Disorders | 281 | ||
| Chapter Outline | 281 | ||
| Symptoms and Signs of Ataxic Disorders | 281 | ||
| Symptoms in Patients with Ataxia | 281 | ||
| Gait Disturbances | 281 | ||
| Limb Ataxia | 281 | ||
| Truncal Ataxia | 281 | ||
| Dysarthria and Bulbar Symptoms | 281 | ||
| Visual Symptoms | 281 | ||
| Symptoms in Sensory Ataxia | 281 | ||
| Neurological Signs in Patients with Cerebellar Ataxia | 281 | ||
| Stance and Gait | 282 | ||
| Limb Incoordination | 282 | ||
| Dysmetria. | 282 | ||
| Kinetic (Intention) Tremor. | 282 | ||
| Action Tremor. | 282 | ||
| Other Types of Tremor. | 282 | ||
| Dysdiadochokinesia. | 282 | ||
| Abnormalities of Muscle Tone and Strength | 282 | ||
| Oculomotor Disturbances | 282 | ||
| Disorders of Pursuit. | 283 | ||
| Disorders of Saccades. | 283 | ||
| Other Saccadic Intrusions. | 283 | ||
| Nystagmus. | 283 | ||
| Vestibulo-Ocular Reflex. | 283 | ||
| Speech and Bulbar Function | 283 | ||
| Cognitive-Affective Features | 283 | ||
| Neurological Signs in Patients with Sensory Ataxia | 283 | ||
| Diagnostic Approach to Ataxia | 283 | ||
| References | 286 | ||
| References | 287 | ||
| 23 Diagnosis and Assessment of Parkinson Disease and Other Movement Disorders | 288 | ||
| Chapter Outline | 288 | ||
| Parkinsonism | 289 | ||
| Motor Abnormalities | 290 | ||
| Cognitive, Autonomic, and Sensory Abnormalities | 291 | ||
| Onset and Course | 292 | ||
| Examination and Clinical Signs | 292 | ||
| Differential Diagnosis | 293 | ||
| Tremor | 295 | ||
| Common Symptoms | 295 | ||
| Rest Tremor | 295 | ||
| Postural Tremor | 296 | ||
| Other Types of Tremor | 296 | ||
| Other Clues in the History | 297 | ||
| Examination | 297 | ||
| Dystonia | 300 | ||
| Common Symptoms | 300 | ||
| Examination | 302 | ||
| Chorea | 302 | ||
| Common Symptoms | 302 | ||
| Other Clues in the History | 303 | ||
| Examination | 304 | ||
| Tardive Dyskinesia | 304 | ||
| Ballism | 305 | ||
| Tics | 305 | ||
| Common Symptoms | 306 | ||
| Examination | 307 | ||
| Myoclonus | 307 | ||
| Common Symptoms | 307 | ||
| Examination | 308 | ||
| Miscellaneous Movement Disorders | 309 | ||
| Investigation of Movement Disorders | 310 | ||
| References | 314 | ||
| References | 315 | ||
| 24 Gait Disorders | 317 | ||
| Chapter Outline | 317 | ||
| Physiological and Biomechanical Aspects of Gait | 317 | ||
| Anatomical Aspects of Gait | 317 | ||
| History: Common Symptoms and Associations | 318 | ||
| Weakness | 318 | ||
| Slowness and Stiffness | 318 | ||
| Imbalance | 318 | ||
| Falls | 319 | ||
| Sensory Symptoms and Pain | 319 | ||
| Urinary Incontinence | 319 | ||
| Cognitive Changes | 319 | ||
| Examination of Posture and Walking | 319 | ||
| Arising from Sitting | 319 | ||
| Stance | 319 | ||
| Trunk Posture | 320 | ||
| Postural Responses | 321 | ||
| Walking | 321 | ||
| Initiation of Gait | 321 | ||
| Stepping | 321 | ||
| Turning | 321 | ||
| More Challenging Tests of Walking | 321 | ||
| Associated and Synergistic Limb Movements While Walking | 321 | ||
| Motor and Sensory Examination | 321 | ||
| Discrepancies on Examination of Gait | 322 | ||
| Classification of Gait Patterns | 322 | ||
| Lower Level Gait Disorders | 322 | ||
| Myopathic Weakness and Gait | 322 | ||
| Neurogenic Weakness and Gait | 322 | ||
| Sensory Ataxia | 322 | ||
| Vestibular Imbalance, Vertigo, and Gait | 322 | ||
| Middle-Level Gait Disorders | 323 | ||
| Spastic Gait | 323 | ||
| Cerebellar Ataxia | 323 | ||
| Spastic Ataxia | 323 | ||
| Hypokinetic (Parkinsonian) Gait | 324 | ||
| Choreic Gait | 324 | ||
| Dystonic Gait | 324 | ||
| Mixed Movement Disorders and Gait | 324 | ||
| Tremor of the Trunk and Legs | 325 | ||
| Action Myoclonus | 325 | ||
| Higher Level Gait Disorders | 325 | ||
| Hypokinetic Higher Level and Freezing Gait Patterns | 325 | ||
| Elderly Gait Patterns, Cautious Gaits, and Fear of Falling | 327 | ||
| Perceptions of Instability and Illusions of Movement | 327 | ||
| Reckless Gait Patterns | 327 | ||
| Hysterical and Psychogenic Gait Disorders | 327 | ||
| Musculoskeletal Disorders and Antalgic Gait | 328 | ||
| Skeletal Deformity and Joint Disease | 328 | ||
| Painful (Antalgic) Gaits | 328 | ||
| References | 328 | ||
| References | 329 | ||
| 25 Hemiplegia and Monoplegia | 330 | ||
| Chapter Outline | 330 | ||
| Anatomy and Physiology | 330 | ||
| Motor System Anatomy | 330 | ||
| Pyramidal Tract | 330 | ||
| Basal Ganglia | 330 | ||
| Cerebellum | 330 | ||
| Localization of Motor Deficits | 331 | ||
| Hemiplegia | 331 | ||
| Cerebral Lesions | 331 | ||
| Cortical Lesions | 331 | ||
| Infarction. | 331 | ||
| Middle Cerebral Artery. | 331 | ||
| Anterior Cerebral Artery. | 332 | ||
| Posterior Cerebral Artery. | 332 | ||
| Mass Lesion. | 332 | ||
| Subcortical Lesions | 332 | ||
| Infarction. | 332 | ||
| Lenticulostriate Arteries. | 332 | ||
| Thalamoperforate Arteries. | 332 | ||
| Demyelinating Disease. | 332 | ||
| Multiple Sclerosis. | 332 | ||
| Acute Disseminated Encephalomyelitis. | 332 | ||
| Progressive Multifocal Leukoencephalopathy. | 332 | ||
| Migraine. | 333 | ||
| Seizures. | 333 | ||
| Tumors. | 333 | ||
| Infections. | 333 | ||
| Alternating Hemiplegia of Childhood. | 333 | ||
| Hemiconvulsion–Hemiplegia–Epilepsy Syndrome. | 333 | ||
| Brainstem Lesions | 333 | ||
| Brainstem Motor Organization | 333 | ||
| Common Lesions | 334 | ||
| Spinal Lesions | 334 | ||
| Spinal Hemisection (Brown–Séquard Syndrome) | 334 | ||
| Transverse Myelitis | 334 | ||
| Spinal Cord Compression | 334 | ||
| Spinal Cord Infarction | 334 | ||
| Peripheral Lesions | 335 | ||
| Psychogenic Hemiplegia | 335 | ||
| Monoplegia | 336 | ||
| Cerebral Lesions | 336 | ||
| Infarction | 336 | ||
| Transient Ischemic Attack | 336 | ||
| Migraine | 336 | ||
| Seizure | 336 | ||
| Multiple Sclerosis | 336 | ||
| Tumors | 336 | ||
| Infections | 336 | ||
| Brainstem Lesions | 336 | ||
| Spinal Lesions | 336 | ||
| Peripheral Lesions | 336 | ||
| Pressure Palsies | 336 | ||
| Hereditary Neuropathy with Predisposition to Pressure Palsies. | 337 | ||
| Pressure Palsies in Polyneuropathy. | 337 | ||
| Mononeuropathies | 337 | ||
| Median Nerve. | 337 | ||
| Carpal Tunnel Syndrome. | 337 | ||
| Anterior Interosseus Syndrome. | 338 | ||
| Pronator Teres Syndrome. | 338 | ||
| Ulnar Nerve. | 338 | ||
| Radial Nerve Palsy. | 338 | ||
| Femoral Neuropathy. | 338 | ||
| Sciatic Neuropathy. | 338 | ||
| Peroneal (Fibular) Neuropathy. | 338 | ||
| Radiculopathies | 338 | ||
| Plexopathies | 339 | ||
| Brachial and Lumbar Plexitis (or Plexopathy). | 339 | ||
| Neoplastic Plexus Infiltration. | 339 | ||
| Radiation Plexopathy. | 339 | ||
| Plexopathy from Hematomas. | 339 | ||
| Plexus Trauma. | 339 | ||
| Thoracic Outlet Syndrome. | 339 | ||
| Diabetic Amyotrophy. | 340 | ||
| Neuronopathies | 340 | ||
| Monomelic Amyotrophy. | 340 | ||
| Poliomyelitis. | 340 | ||
| Multifocal Motor Neuropathy. | 340 | ||
| Pitfalls in the Differential Diagnosis of Hemiplegia and Monoplegia | 340 | ||
| Pitfalls in the Differential Diagnosis of Hemiplegia and Monoplegia | 341 | ||
| Focal Weakness of Apparently Central Origin | 341 | ||
| Focal Weakness That Appears to Be Central: Cerebral Cortex, Internal Capsule, Brainstem, or Spinal Cord? | 341 | ||
| Focal Weakness That Appears to Be Central: Migraine, TIA, or Seizure? | 341 | ||
| Weakness of the Hand and Wrist | 342 | ||
| Weakness in Intrinsic Muscles of the Hand: Median Nerve, Ulnar Nerve, Brachial Plexus, or Small Cerebral Cortical Lesion? | 342 | ||
| Weakness of the Wrist: Radial Neuropathy or Small Cerebral Cortical Infarcts? | 342 | ||
| Leg Weakness | 342 | ||
| Peroneal Nerve Palsy or Paramedian Cerebral Cortical Lesion? | 342 | ||
| Cauda Equina Lesion, Myelopathy, or Paramedian Cerebral Cortical Lesion? | 342 | ||
| References | 340 | ||
| References | 343 | ||
| 26 Paraplegia and Spinal Cord Syndromes | 344 | ||
| Chapter Outline | 344 | ||
| Common Spinal Cord Syndromes | 344 | ||
| Spinal Shock | 344 | ||
| Incomplete Lesions of the Spinal Cord | 344 | ||
| Unilateral Transverse Lesion | 344 | ||
| Central Cord Syndrome | 345 | ||
| Anterior Spinal Artery Syndrome | 345 | ||
| Anterior Horn and Pyramidal Tract Syndromes | 345 | ||
| Combined Posterior and Lateral Column Disease | 346 | ||
| Characteristic Clinical Features of Lesions at Different Levels | 346 | ||
| Foramen Magnum and Upper Cervical Spine | 346 | ||
| Lower Cervical and Upper Thoracic Spine | 347 | ||
| Thoracic Levels | 347 | ||
| Conus Medullaris and Cauda Equina | 347 | ||
| Pain and Autonomic Dysfunction | 348 | ||
| Pain Syndromes | 348 | ||
| Local Pain | 348 | ||
| Projected Pain | 348 | ||
| Central Neurogenic Pain | 348 | ||
| Autonomic Dysreflexia | 349 | ||
| Bowel and Bladder Dysfunction | 349 | ||
| References | 349 | ||
| References | 350 | ||
| 27 Proximal, Distal, and Generalized Weakness | 351 | ||
| Chapter Outline | 351 | ||
| Clinical Presentation by Affected Region | 351 | ||
| General Considerations | 351 | ||
| Ocular Muscles | 352 | ||
| Facial and Bulbar Muscles | 352 | ||
| Neck, Diaphragm, and Axial Muscles | 352 | ||
| Proximal Upper Extremity | 352 | ||
| Distal Upper Extremity | 353 | ||
| Proximal Lower Extremity | 353 | ||
| Distal Lower Extremity | 353 | ||
| Bedside Examination of the Weak Patient | 353 | ||
| Observation | 353 | ||
| Muscle Bulk and Deformities | 354 | ||
| Muscle Palpation, Percussion, and Range of Motion | 355 | ||
| Muscle Tone | 355 | ||
| Strength | 355 | ||
| Fatigue | 356 | ||
| Reflexes | 356 | ||
| Sensory Disturbances | 356 | ||
| Peripheral Nerve Enlargement | 356 | ||
| Fasciculations, Cramps, and Other Abnormal Muscle Movements | 357 | ||
| Functional Evaluation of the Weak Patient | 357 | ||
| Walking | 357 | ||
| Arising from the Floor | 357 | ||
| Stepping onto a Stool | 357 | ||
| Psychogenic Weakness | 358 | ||
| Clinical Investigations in Muscular Weakness | 358 | ||
| Serum Creatine Kinase | 358 | ||
| Electromyography | 358 | ||
| Muscle Biopsy | 359 | ||
| Genetic Testing | 359 | ||
| Exercise Testing | 359 | ||
| Differential Diagnosis by Affected Region and Other Manifestations of Weakness | 360 | ||
| Disorders with Prominent Ocular Weakness | 360 | ||
| Disorders with Distinctive Facial or Bulbar Weakness | 361 | ||
| Disorders with Prominent Respiratory Weakness | 362 | ||
| Disorders with Distinctive Shoulder-Girdle or Arm Weakness | 362 | ||
| Disorders with Prominent Hip-Girdle or Leg Weakness | 362 | ||
| Disorders with Fluctuating Weakness | 363 | ||
| Disorders Exacerbated by Exercise | 364 | ||
| Disorders with Constant Weakness | 364 | ||
| Acquired Disorders Causing Weakness | 365 | ||
| Lifelong Disorders | 366 | ||
| Lifelong Nonprogressive Disorders | 366 | ||
| Lifelong Disorders Characterized by Progressive Weakness | 366 | ||
| Other Conditions | 367 | ||
| References | 367 | ||
| References | 368 | ||
| 28 Muscle Pain and Cramps | 369 | ||
| Chapter Outline | 369 | ||
| General Features of Pain | 369 | ||
| Muscle Pain: Basic Concepts | 369 | ||
| Nociceptor Terminal Stimulation and Sensitization | 369 | ||
| Nociceptive Axons | 370 | ||
| Clinical Features of Muscle Pain | 372 | ||
| General Features of Muscle Pain | 372 | ||
| Evaluation of Muscle Discomfort | 372 | ||
| Muscle Discomfort: Specific Causes | 373 | ||
| Myopathies with Muscle Pain | 373 | ||
| Muscle Cramps | 376 | ||
| Other Involuntary Muscle Contraction Syndromes | 376 | ||
| Myalgia Syndromes without Chronic Myopathy | 376 | ||
| References | 377 | ||
| References | 378 | ||
| 29 Hypotonic (Floppy) Infant | 379 | ||
| Chapter Outline | 379 | ||
| Approach to Diagnosis | 379 | ||
| History | 379 | ||
| Physical Examination | 379 | ||
| General Features of Hypotonia | 379 | ||
| Localization | 380 | ||
| Diagnostic Studies | 381 | ||
| Neuroimaging | 381 | ||
| Electroencephalography | 381 | ||
| Creatine Kinase | 381 | ||
| Metabolic Studies | 382 | ||
| Nerve Conduction Studies and Electromyography | 382 | ||
| Muscle Biopsy | 382 | ||
| Nerve Biopsy | 382 | ||
| Genetic Testing | 382 | ||
| Serology | 382 | ||
| Specific Disorders Associated with Hypotonia in Infancy | 383 | ||
| Cerebral Disorders | 383 | ||
| Chromosomal Disorders | 383 | ||
| Chronic Nonprogressive Encephalopathy | 383 | ||
| Chronic Progressive Encephalopathy | 383 | ||
| Benign Congenital Hypotonia | 383 | ||
| Combined Cerebral and Motor Unit Disorders | 383 | ||
| Acid Maltase Deficiency | 384 | ||
| Congenital Myotonic Dystrophy | 384 | ||
| Infantile Facioscapulohumeral Dystrophy | 384 | ||
| Syndromic Congenital Muscular Dystrophies | 384 | ||
| Congenital Disorders of Glycosylation | 384 | ||
| Lysosomal Disorders | 384 | ||
| Infantile Neuroaxonal Dystrophy | 384 | ||
| Spinal Cord Disorders | 384 | ||
| Acquired Spinal Cord Lesions | 384 | ||
| Spinal Muscular Atrophy | 385 | ||
| Infantile Spinal Muscular Atrophy with Respiratory Distress Type 1 | 385 | ||
| X-linked Spinal Muscular Atrophy | 385 | ||
| Peripheral Nerve Disorders | 385 | ||
| Neuromuscular Junction Disorders | 386 | ||
| Juvenile Myasthenia Gravis | 386 | ||
| Neonatal Myasthenia | 386 | ||
| Congenital Myasthenic Syndromes | 386 | ||
| Infant Botulism | 386 | ||
| Muscle Disorders | 386 | ||
| Congenital Myopathies | 387 | ||
| Centronuclear Myopathy. | 387 | ||
| Nemaline Myopathy. | 387 | ||
| Central Core Disease. | 387 | ||
| Nonsyndromic Congenital Muscular Dystrophies | 387 | ||
| Merosin-Deficient Congenital Muscular Dystrophy. | 387 | ||
| Ullrich Congenital Muscular Dystrophy. | 387 | ||
| Summary | 387 | ||
| References | 387 | ||
| References | 388 | ||
| 30 Sensory Abnormalities of the Limbs, Trunk, and Face | 390 | ||
| Chapter Outline | 390 | ||
| Anatomy and Physiology | 390 | ||
| Peripheral Pathways | 390 | ||
| Spinal Cord Pathways | 390 | ||
| Brain Pathways | 390 | ||
| Brainstem | 390 | ||
| Thalamus | 390 | ||
| Cerebral Cortex | 390 | ||
| Sensory Input Processing | 390 | ||
| Approach to Localization and Diagnosis | 392 | ||
| Sensory Abnormalities | 392 | ||
| Localization of Sensory Abnormalities | 392 | ||
| Peripheral Sensory Lesions | 393 | ||
| Spinal Sensory Lesions | 394 | ||
| Sensory Level. | 394 | ||
| Dissociated Sensory Loss. | 395 | ||
| Suspended Sensory Loss. | 395 | ||
| Sacral Sparing. | 395 | ||
| Brainstem Sensory Lesions | 395 | ||
| Cerebral Sensory Lesions | 396 | ||
| Thalamic Lesions. | 396 | ||
| Cortical Lesions. | 396 | ||
| Common Sensory Syndromes | 396 | ||
| Peripheral Syndromes | 396 | ||
| Sensory Polyneuropathy | 396 | ||
| Diabetic Neuropathies | 397 | ||
| Small Fiber Neuropathy | 397 | ||
| Acquired Immunodeficiency Syndrome-Associated Neuropathies | 397 | ||
| Toxic Neuropathies | 397 | ||
| Amyloid Neuropathy | 397 | ||
| Proximal Sensory Loss | 397 | ||
| Temperature-Dependent Sensory Loss | 397 | ||
| Acute Inflammatory Demyelinating Polyradiculoneuropathy | 397 | ||
| Mononeuropathy | 398 | ||
| Carpal Tunnel Syndrome. | 398 | ||
| Ulnar Neuropathy. | 398 | ||
| Radial Neuropathy. | 398 | ||
| Radiculopathy | 398 | ||
| Spinal Syndromes | 398 | ||
| Myelopathy | 398 | ||
| Syringomyelia | 399 | ||
| Spinal Hemisection | 399 | ||
| Tabes Dorsalis and Related Disorders | 399 | ||
| Brain Syndromes | 399 | ||
| Thalamic Infarction and Hemorrhage | 399 | ||
| Thalamic Pain Syndrome (Central Post-Stroke Pain) | 399 | ||
| Trigeminal Neuralgia | 399 | ||
| Mental Neuropathy (Numb Chin Syndrome) | 399 | ||
| Cortical Infarction | 399 | ||
| Deficits of Higher Sensory Perception | 399 | ||
| Functional (or Psychogenic) Sensory Loss | 400 | ||
| Pitfalls | 400 | ||
| Pitfalls | 401 | ||
| Acute Inflammatory Demyelinating Polyneuropathy in a Patient with Known Peripheral Neuropathy | 401 | ||
| Myelopathy vs Midline Cerebral Lesion | 401 | ||
| References | 400 | ||
| References | 402 | ||
| 31 Arm and Neck Pain | 403 | ||
| Chapter Outline | 403 | ||
| Clinical Assessment | 403 | ||
| History | 403 | ||
| Neurological Causes of Pain: Sites That Can Trigger Pain | 403 | ||
| Muscle Spasm. | 403 | ||
| Central Pain. | 403 | ||
| Nerve Root Pain. | 403 | ||
| Ulnar Nerve Pain. | 403 | ||
| Median Nerve Pain. | 403 | ||
| Plexus Pain. | 403 | ||
| Non-Neurological Causes of Neck Pain and Brachialgia | 404 | ||
| Examination | 405 | ||
| Motor Signs—Atrophy and Weakness | 405 | ||
| Sensory Signs | 405 | ||
| Tendon Reflexes | 406 | ||
| Pathology and Clinical Syndromes | 406 | ||
| Spinal Cord Syndromes | 406 | ||
| Intramedullary Lesions | 406 | ||
| Extramedullary Lesions | 406 | ||
| Other Cord Compression Syndromes | 406 | ||
| Radiculitis | 407 | ||
| Brachial Plexopathy | 407 | ||
| Brachial Neuritis (Neuralgic Amyotrophy, Parsonage-Turner Syndrome) | 407 | ||
| Brachial Plexopathy in Cancer Patients | 407 | ||
| Thoracic Outlet Syndrome | 407 | ||
| Suprascapular Nerve Entrapment | 407 | ||
| Carpal Tunnel Syndrome | 407 | ||
| Ulnar Entrapment at the Elbow | 408 | ||
| Radial Nerve–Posterior Interosseus Nerve Syndrome | 408 | ||
| Complex Regional Pain Syndrome | 408 | ||
| “In-Between” Neurogenic and Non-Neurogenic Pain Syndrome—Whiplash Injury | 409 | ||
| Rheumatoid Arthritis of the Spine | 409 | ||
| Non-Neurological Neck/Arm Pain Syndromes | 409 | ||
| Fibromyalgia and Myofascial Syndrome | 410 | ||
| Polymyalgia Rheumatica | 410 | ||
| Tendonitis, Bursitis, and Arthritis | 410 | ||
| Shoulder. | 410 | ||
| Elbow | 410 | ||
| Epicondylitis. | 410 | ||
| Olecranon Bursitis. | 410 | ||
| Wrist | 410 | ||
| Tendonitis. | 410 | ||
| Hands. | 410 | ||
| References | 410 | ||
| Further Reading | 411 | ||
| 32 Lower Back and Lower Limb Pain | 412 | ||
| Chapter Outline | 412 | ||
| Anatomy and Physiology | 412 | ||
| Approach to Diagnosis of Low Back and Leg Pain | 412 | ||
| History and Examination | 412 | ||
| Differential Diagnosis of Lower Back and Leg Pain | 414 | ||
| Evaluation | 414 | ||
| Magnetic Resonance Imaging | 415 | ||
| Myelography and Postmyelographic Computed Tomography | 415 | ||
| Nerve Conduction Studies and Electromyography | 415 | ||
| Radiography | 417 | ||
| Bone Scan | 417 | ||
| Clinical Syndromes | 417 | ||
| Lower Back and Leg Pain | 417 | ||
| Lumbar Spine Stenosis | 417 | ||
| Cauda Equina Syndrome and Conus Medullaris Syndrome | 417 | ||
| Lumbosacral Radiculopathy | 417 | ||
| Arachnoiditis | 418 | ||
| Plexopathy | 418 | ||
| Neoplastic Lumbosacral Plexopathy. | 418 | ||
| Plexus Injury from Retroperitoneal Abscess. | 418 | ||
| Plexus Injury from Retroperitoneal Hematoma. | 418 | ||
| Leg Pain without Lower Back Pain | 418 | ||
| Peripheral Nerve Syndromes | 418 | ||
| Femoral Neuropathy. | 419 | ||
| Meralgia Paresthetica. | 419 | ||
| Sciatic Neuropathy. | 419 | ||
| Piriformis Syndrome. | 419 | ||
| Peroneal (Fibular) Neuropathy. | 419 | ||
| Polyneuropathy. | 419 | ||
| Plexopathy | 420 | ||
| Lumbosacral Plexitis. | 420 | ||
| Diabetic Amyotrophy. | 420 | ||
| Herpes Zoster | 420 | ||
| Claudication of Leg Arteries | 420 | ||
| Lower Back Pain without Leg Pain | 420 | ||
| Mechanical Lower Back Pain | 420 | ||
| Sacroiliac Joint Inflammation (Sacroilitis) | 420 | ||
| Facet Joint Pain Syndrome | 420 | ||
| Lumbar Spine Osteomyelitis | 421 | ||
| Lumbar Spine Compression | 421 | ||
| Lumbar Diskitis | 421 | ||
| Spinal epidural abscess | 421 | ||
| Pitfalls | 421 | ||
| Pitfalls | 422 | ||
| Low Back Pain: Disc, Tumor, Diskitis, or Epidural Abscess | 422 | ||
| Lower Back Pain from Intra-abdominal and Pelvic Causes | 422 | ||
| Lower Back and Leg Pain from Arterial Insufficiency | 422 | ||
| References | 421 | ||
| References | 423 | ||
| II Neurological Investigations and Related Clinical Neurosciences | 425 | ||
| A General Principles | 425 | ||
| 33 Laboratory Investigations in Diagnosis and Management of Neurological Disease | 425 | ||
| Chapter Outline | 425 | ||
| Diagnostic Yield of Laboratory Tests | 426 | ||
| Interpretation of Results of Laboratory Investigations | 426 | ||
| Risk and Cost of Investigations | 427 | ||
| Risk-to-Benefit Analysis | 427 | ||
| Lumbar Puncture | 427 | ||
| Cerebral Arteriography | 427 | ||
| Brain Biopsy | 427 | ||
| Cost-to-Benefit Analysis | 428 | ||
| Prioritization of Tests | 428 | ||
| Reliability of Laboratory Investigations | 429 | ||
| Decision Analysis | 429 | ||
| Research Investigations and Teaching Hospitals | 429 | ||
| Patient Confidentiality | 429 | ||
| Role of Laboratory Investigations in Neurological Disease Management | 429 | ||
| B Clinical Neurophysiology | 430 | ||
| 34 Electroencephalography and Evoked Potentials | 430 | ||
| Chapter Outline | 430 | ||
| Electroencephalography | 430 | ||
| Physiological Principles of Electroencephalography | 430 | ||
| Normal Electroencephalographic Activities | 432 | ||
| Common Types of Electroencephalographic Abnormalities | 433 | ||
| Focal Polymorphic Slow Activity | 433 | ||
| Generalized Polymorphic Slow Activity | 433 | ||
| Intermittent Monomorphic Slow Activity | 433 | ||
| Voltage Attenuation | 433 | ||
| Epileptiform Discharges | 433 | ||
| Recording Techniques | 433 | ||
| Clinical Uses of Electroencephalography | 434 | ||
| Epilepsy | 435 | ||
| Focal Cerebral Lesions | 438 | ||
| Altered States of Consciousness | 439 | ||
| Metabolic Encephalopathies | 440 | ||
| Hypoxia | 440 | ||
| Infectious Diseases | 440 | ||
| Brain Death | 442 | ||
| Aging and Dementia | 442 | ||
| Continuous EEG Monitoring in the Intensive Care Unit | 442 | ||
| cEEG Monitoring for Nonconvulsive Seizures | 443 | ||
| Electrographic Identification of Nonconvulsive Seizures | 444 | ||
| The “Ictal-Interictal Continuum” | 444 | ||
| Periodic Discharges | 445 | ||
| Stimulus-Induced Rhythmic, Periodic, or Ictal Discharges | 445 | ||
| Quantitative EEG | 445 | ||
| Magnetoencephalography | 448 | ||
| Magnetoencephalography | 449 | ||
| Evoked Potentials | 448 | ||
| Evoked Potentials | 449 | ||
| Visual Evoked Potentials | 449 | ||
| Normal Visual Evoked Potentials | 449 | ||
| Visual Evoked Potentials in Neurological Disease | 450 | ||
| Brainstem Auditory Evoked Potentials | 451 | ||
| Normal Brainstem Auditory Evoked Potentials | 451 | ||
| Brainstem Auditory Evoked Potentials in Neurological Disease | 451 | ||
| Somatosensory Evoked Potentials | 452 | ||
| Median Nerve Somatosensory Evoked Potentials | 453 | ||
| Posterior Tibial Nerve Somatosensory Evoked Potentials | 454 | ||
| Somatosensory Evoked Potentials in Neurological Disease | 455 | ||
| Motor Evoked Potentials and Magnetic Coil Stimulation | 455 | ||
| Intraoperative Monitoring | 448 | ||
| Intraoperative Monitoring | 457 | ||
| References | 448 | ||
| References | 460 | ||
| 35 Clinical Electromyography | 461 | ||
| Chapter Outline | 461 | ||
| Nerve Conduction Studies | 461 | ||
| Principles | 461 | ||
| Stimulators | 461 | ||
| Recording Electrodes | 462 | ||
| Recording Procedure | 462 | ||
| Motor Nerve Conduction Studies | 462 | ||
| Sensory Nerve Conduction Studies | 463 | ||
| Mixed Nerve Conduction Studies | 464 | ||
| Segmental Stimulation in Short Increments | 464 | ||
| Physiological Variability and Common Sources of Error | 464 | ||
| Temperature | 465 | ||
| Age | 465 | ||
| Height and Nerve Segment Lengths | 465 | ||
| Anomalies | 465 | ||
| Martin–Gruber Anastomosis. | 465 | ||
| Accessory Deep Peroneal Nerve. | 466 | ||
| Pre- and Post-Fixed Brachial Plexus. | 466 | ||
| Riche–Cannieu Anastomosis. | 466 | ||
| Temporal Dispersion and Phase Cancellation | 466 | ||
| Intertrial Variability | 466 | ||
| Electrodiagnosis by Nerve Conduction Studies | 466 | ||
| Focal Nerve Lesions | 466 | ||
| Demyelinative Mononeuropathy. | 468 | ||
| Axon-Loss Mononeuropathy. | 469 | ||
| Preganglionic (Intraspinal Canal) Lesions. | 469 | ||
| Generalized Polyneuropathies | 470 | ||
| Axonal Polyneuropathies. | 470 | ||
| Demyelinating Polyneuropathies. | 470 | ||
| Needle Electromyographic Examination | 471 | ||
| Principles and Techniques | 471 | ||
| Insertional and Spontaneous Activity | 471 | ||
| Normal Insertional and Spontaneous Activity | 471 | ||
| End-Plate Noise (see Video 35.1, available at http://www.experconsult.com). | 471 | ||
| End-Plate Spikes (see Video 35.2, available at http://www.experconsult.com). | 471 | ||
| Abnormal Insertional and Spontaneous Activity | 471 | ||
| Prolonged Versus Decreased Insertional Activity. | 471 | ||
| Fibrillation Potentials (see Video 35.3, available at http://www.experconsult.com). | 472 | ||
| Fasciculation Potentials (see Video 35.4, available at http://www.experconsult.com). | 474 | ||
| Myotonic Discharges (see Video 35.5, available at http://www.experconsult.com). | 474 | ||
| Myokymic Discharges (see Video 35.6, available at http://www.experconsult.com). | 474 | ||
| Complex Repetitive Discharges (see Video 35.7, available at http://www.experconsult.com). | 474 | ||
| Neuromyotonic Discharges (see Video 35.8, available at http://www.experconsult.com). | 474 | ||
| Cramp Discharges (see Video 35.9, available at http://www.experconsult.com). | 475 | ||
| Voluntary Motor Unit Action Potentials | 475 | ||
| MUAP Morphology (see Videos 35.10, 35.11, 35.12, 35.13, available at http://www.experconsult.com) | 475 | ||
| Amplitude. | 475 | ||
| Duration. | 475 | ||
| Phases. | 475 | ||
| MUAP Stability (see Video 35.14, available at http://www.experconsult.com) | 476 | ||
| MUAP Firing Patterns (see Videos 35.10, 35.13, 35.15, 35.16, available at http://www.experconsult.com) | 476 | ||
| Electrodiagnosis by Needle Electromyography | 476 | ||
| Lower Motor Neuron Disorders | 476 | ||
| Radiculopathies. | 477 | ||
| Plexopathies. | 477 | ||
| Mononeuropathies. | 477 | ||
| Peripheral Polyneuropathies. | 478 | ||
| Anterior Horn Cell Disorders. | 478 | ||
| Upper Motor Neuron Lesions | 479 | ||
| Myopathic Disorders | 479 | ||
| Specialized Electrodiagnostic Studies | 480 | ||
| F Wave | 480 | ||
| A Wave | 480 | ||
| H Reflex | 480 | ||
| Blink Reflex | 481 | ||
| Repetitive Nerve Stimulation | 481 | ||
| Principles | 481 | ||
| Slow Repetitive Nerve Stimulation | 482 | ||
| Rapid Repetitive Nerve Stimulation | 483 | ||
| Single-Fiber Electromyography | 483 | ||
| Fiber Density | 484 | ||
| Jitter | 484 | ||
| References | 485 | ||
| References | 486 | ||
| 36 Neuromodulation and Transcranial Magnetic Stimulation | 487 | ||
| Chapter Outline | 487 | ||
| Methods and Their Neurophysiological Background | 487 | ||
| Stimulation Parameters for Diagnostic Use of TMS | 487 | ||
| Central Motor Conduction Measurements | 487 | ||
| Motor Excitability Measurements | 488 | ||
| Motor Thresholds | 488 | ||
| MEP Recruitment Curve (Stimulus Response Curve; Input–Output Curve) | 488 | ||
| Silent Period and Long-Interval Intracortical Inhibition (LICI) | 488 | ||
| Short-Interval Intracortical Inhibition (SICI) and Intracortical Facilitation (ICF) | 489 | ||
| Short-Interval Intracortical Facilitation (SICF) | 489 | ||
| Short-Latency and Long-Latency Afferent Inhibition (SAI and LAI) | 489 | ||
| Surround Inhibition (SI) | 489 | ||
| Other Inhibitory Phenomena of the Motor Cortex | 489 | ||
| Motor Cortical Plasticity Measurements—Paired Associative Stimulation | 490 | ||
| Clinical Applications for Diagnostic Use of TMS | 490 | ||
| Movement Disorders | 490 | ||
| Parkinson Disease and Parkinson Plus Syndromes | 490 | ||
| Dystonia | 491 | ||
| Huntington Disease | 492 | ||
| Other Neurodegenerative Disorders | 492 | ||
| Dementia and Mild Cognitive Impairment | 492 | ||
| Amyotrophic Lateral Sclerosis | 492 | ||
| Cerebellar Disorders | 492 | ||
| Epilepsy and Antiepileptic Drugs | 492 | ||
| Stroke | 492 | ||
| Multiple Sclerosis (MS) | 493 | ||
| Migraine | 493 | ||
| Cervical Myelopathy and Other Spinal Cord Lesions | 493 | ||
| Therapeutic Applications | 493 | ||
| Rationale for rTMS | 493 | ||
| Basic Principles of rTMS | 493 | ||
| Current Concepts of Therapeutic Application of rTMS | 494 | ||
| Depression | 494 | ||
| Auditory Hallucinations and Negative Symptoms in Schizophrenia | 494 | ||
| Parkinson Disease | 494 | ||
| Dystonia | 495 | ||
| Pain and Migraine | 495 | ||
| Tinnitus | 495 | ||
| Stroke with Motor Deficits, Aphasia, and Hemispatial Neglect | 495 | ||
| Amyotrophic Lateral Sclerosis | 495 | ||
| Epilepsy | 496 | ||
| Conclusion and Outlook | 496 | ||
| References | 496 | ||
| References | 497 | ||
| 37 Deep Brain Stimulation | 500 | ||
| Chapter Outline | 500 | ||
| Parkinson Disease | 501 | ||
| Clinical Evidence: Randomized Controlled Trials | 501 | ||
| Dystonia | 503 | ||
| Tremor | 503 | ||
| Neuropsychiatric Disorders | 503 | ||
| Tourette Syndrome | 503 | ||
| Depression | 504 | ||
| Obsessive-Compulsive Disorder | 504 | ||
| Drug Addiction | 504 | ||
| Pain | 505 | ||
| Epilepsy | 505 | ||
| Closed Loop Stimulation—The Epilepsy Experience | 505 | ||
| Conclusions and the Future of DBS | 505 | ||
| References | 505 | ||
| References | 506 | ||
| 38 Intraoperative Monitoring | 509 | ||
| Chapter Outline | 509 | ||
| Introduction | 509 | ||
| Techniques | 509 | ||
| Spinal Cord Monitoring Techniques | 509 | ||
| Interpretation | 511 | ||
| Monitoring | 511 | ||
| Testing | 511 | ||
| Response to Change | 511 | ||
| Prediction of Deficits | 511 | ||
| Anesthesia | 512 | ||
| Clinical Settings | 512 | ||
| References | 512 | ||
| References | 513 | ||
| C Neuroimaging | 514 | ||
| 39 Structural Imaging using Magnetic Resonance Imaging and Computed Tomography | 514 | ||
| Chapter Outline | 514 | ||
| Computed Tomography | 514 | ||
| Magnetic Resonance Imaging | 515 | ||
| Basic Principles | 515 | ||
| T1 and T2 Relaxation Times | 516 | ||
| Repetition Time and Time to Echo | 517 | ||
| Tissue Contrast (T1, T2, and Proton Density Weighting) | 518 | ||
| Magnetic Resonance Image Reconstruction | 519 | ||
| Spin Echo and Fast (Turbo) Spin Echo Techniques | 521 | ||
| Gradient-Recalled Echo Sequences, Partial Flip Angle | 521 | ||
| Inversion Recovery Sequences (FLAIR, STIR) | 522 | ||
| Fat Saturation | 522 | ||
| Echoplanar Imaging | 522 | ||
| Diffusion-Weighted Magnetic Resonance Imaging | 523 | ||
| Perfusion-Weighted Magnetic Resonance Imaging | 523 | ||
| Susceptibility-Weighted Imaging | 523 | ||
| Diffusion Tensor Imaging | 524 | ||
| Magnetization Transfer Contrast Imaging | 524 | ||
| Structural Neuroimaging in the Clinical Practice of Neurology | 520 | ||
| Brain Diseases | 520 | ||
| Brain Tumors | 520 | ||
| Intra-axial Primary Brain Tumors | 520 | ||
| Ganglioglioma and Gangliocytoma. | 520 | ||
| Pilocytic Astrocytomas. | 527 | ||
| Pleomorphic Xanthoastrocytoma. | 528 | ||
| Low-Grade Astrocytomas. | 527 | ||
| Anaplastic Astrocytoma. | 529 | ||
| Oligodendroglioma. | 530 | ||
| Oligoastrocytoma. | 531 | ||
| Gliomatosis Cerebri. | 532 | ||
| Glioblastoma Multiforme. | 532 | ||
| Ependymoma. | 533 | ||
| Lymphoma. | 533 | ||
| Hemangioblastoma. | 534 | ||
| Extra-axial Primary Brain Tumors | 533 | ||
| Meningiomas. | 533 | ||
| Schwannoma. | 536 | ||
| Primitive Neuroectodermal Tumor. | 535 | ||
| Medulloblastoma. | 535 | ||
| Esthesioneuroblastoma. | 536 | ||
| Pineoblastoma. | 535 | ||
| Other Pineal Region Tumors. | 537 | ||
| Pineocytoma. | 537 | ||
| Germ Cell Tumors (Germinoma). | 538 | ||
| Central Neurocytoma. | 539 | ||
| Subependymal Giant Cell Astrocytoma. | 538 | ||
| Choroid Plexus Papilloma. | 538 | ||
| Subependymoma. | 539 | ||
| Tumors in the Sellar and Parasellar Region | 538 | ||
| Pituitary Adenomas. | 538 | ||
| Craniopharyngioma. | 540 | ||
| Metastatic Tumors | 542 | ||
| Advanced Structural Neuroimaging for Planning of Brain Tumor Surgery. | 543 | ||
| Ischemic Stroke | 542 | ||
| Acute Ischemic Stroke. | 542 | ||
| Temporal Evolution of Ischemic Stroke on Magnetic Resonance Imaging | 544 | ||
| Acute Stroke. | 544 | ||
| Subacute Ischemic Stroke (1 Day to 1 Week after Onset). | 547 | ||
| Late Subacute Ischemic Stroke (1 to 3 Weeks after Onset). | 548 | ||
| Chronic Ischemic Stroke (3 Weeks and Older). | 548 | ||
| Stroke Etiology | 548 | ||
| Watershed Ischemic Stroke. | 549 | ||
| Ischemic Stroke of Thromboembolic Origin. | 549 | ||
| Lacunar Ischemic Stroke. | 550 | ||
| Other Cerebrovascular Occlusive Disease | 548 | ||
| Microvascular Ischemic White Matter Lesions, “White Matter Disease,” Binswanger Disease. | 548 | ||
| CADASIL. | 553 | ||
| Hippocampal Sclerosis. | 552 | ||
| Venous Stroke. | 554 | ||
| Cerebral Venous Sinus Thrombosis. | 552 | ||
| Hemorrhagic Cerebrovascular Disease | 557 | ||
| Hyperacute Hemorrhage (0 to 24 Hours). | 558 | ||
| Acute Hemorrhage (1 to 3 Days). | 558 | ||
| Early Subacute Hemorrhage (3 Days to 1 Week). | 558 | ||
| Late Subacute Hemorrhage (1 to 4 Weeks). | 558 | ||
| Chronic Hemorrhage (>4 Weeks). | 558 | ||
| Superficial Siderosis | 559 | ||
| Cerebral Amyloid Angiopathy | 559 | ||
| Infection | 558 | ||
| Bacterial Meningitis. | 559 | ||
| Cerebritis, Abscess. | 559 | ||
| CNS Tuberculosis. | 560 | ||
| Lyme Disease. | 560 | ||
| Cysticercosis. | 560 | ||
| Herpes Simplex Encephalitis. | 561 | ||
| Human Immunodeficiency Virus Encephalitis. | 562 | ||
| Cerebral Toxoplasmosis. | 563 | ||
| Progressive Multifocal Leukoencephalopathy. | 563 | ||
| Cytomegalovirus. | 563 | ||
| Creutzfeldt-Jakob Disease. | 563 | ||
| Noninfectious Encephalitis | 558 | ||
| Limbic Encephalitis. | 563 | ||
| Multiple Sclerosis and Other White Matter Diseases | 558 | ||
| Multiple Sclerosis. | 565 | ||
| Inflammatory and Noninflammatory Lesions of the Corpus Callosum. | 569 | ||
| Acute Disseminated Encephalomyelitis. | 568 | ||
| Neurosarcoidosis. | 568 | ||
| Leukodystrophy. | 569 | ||
| Krabbe Disease. | 569 | ||
| Metachromatic Leukodystrophy. | 569 | ||
| Adrenoleukodystrophy. | 569 | ||
| Radiation Leukoencephalopathy. | 569 | ||
| Posterior Reversible Encephalopathy Syndrome. | 569 | ||
| Central Pontine Myelinolysis. | 570 | ||
| Trauma | 568 | ||
| Traumatic Subarachnoid Hemorrhage. | 568 | ||
| Subdural Hemorrhage. | 571 | ||
| Epidural Hemorrhage. | 572 | ||
| Cortical Contusion. | 573 | ||
| Diffuse Axonal Injury. | 574 | ||
| Cerebral Parenchymal Hematoma. | 574 | ||
| Metabolic and Toxic Disorders | 574 | ||
| Disorders due to Ethanol. | 575 | ||
| Carbon Monoxide Poisoning. | 575 | ||
| Methanol Poisoning. | 575 | ||
| Wilson Disease. | 575 | ||
| Mitochondrial Disease. | 576 | ||
| Genetic and Degenerative Disorders Primarily Causing Ataxia (Cerebellar Disorders) | 574 | ||
| Multiple System Atrophy, Cerebellar Subtype. | 576 | ||
| Spinocerebellar Ataxias. | 576 | ||
| Friedreich Ataxia. | 577 | ||
| Ataxia-Telangiectasia. | 577 | ||
| Fragile X Premutation Syndrome. | 577 | ||
| Genetic and Degenerative Disorders Primarily Causing Parkinsonism or Other Movement Disorders | 578 | ||
| Idiopathic Parkinson Disease. | 579 | ||
| Progressive Supranuclear Palsy. | 579 | ||
| Multiple System Atrophy, Parkinsonian Variant (Striatonigral Degeneration). | 580 | ||
| Huntington Disease. | 580 | ||
| Degenerative Disorders Primarily Causing Dementia | 578 | ||
| Age-Related Involutional Changes. | 578 | ||
| Alzheimer Disease. | 581 | ||
| Frontotemporal Lobar Degeneration, Including Pick Disease. | 581 | ||
| Neurocutaneous Syndromes | 581 | ||
| Neurofibromatosis. | 583 | ||
| Hamartoma. | 583 | ||
| Neurofibroma. | 583 | ||
| Tuberous Sclerosis (Bourneville Disease). | 583 | ||
| Cortical Tubers. | 583 | ||
| Subependymal Nodules. | 583 | ||
| White Matter Lesions. | 583 | ||
| Von Hippel-Lindau Disease. | 583 | ||
| Sturge-Weber Syndrome. | 583 | ||
| Congenital Anomalies of the Brain | 581 | ||
| Holoprosencephaly. | 586 | ||
| Septo-Optic Dysplasia. | 586 | ||
| Dandy-Walker Malformation. | 586 | ||
| Agenesis of the Corpus Callosum. | 586 | ||
| Gray Matter Heterotopia. | 586 | ||
| Pachygyria, Polymicrogyria, Lissencephaly. | 586 | ||
| Schizencephaly. | 586 | ||
| Porencephaly. | 586 | ||
| Hydranencephaly. | 586 | ||
| Lipomas. | 587 | ||
| Non-neoplastic Congenital Cystic Lesions | 581 | ||
| Epidermoid. | 588 | ||
| Dermoid. | 589 | ||
| Colloid Cyst. | 589 | ||
| Arachnoid Cyst. | 589 | ||
| Dilated Virchow-Robin Spaces. | 589 | ||
| Choroid Fissure Cyst. | 590 | ||
| Choroid Plexus Cyst. | 590 | ||
| Ependymal Cyst. | 590 | ||
| Neuroglial Cyst. | 590 | ||
| Vascular Malformations | 594 | ||
| Arteriovenous Malformations. | 595 | ||
| Cavernous Malformation. | 595 | ||
| Developmental Venous Anomaly. | 595 | ||
| Capillary Telangiectasia. | 595 | ||
| Cerebrospinal Fluid Circulation Disorders | 594 | ||
| Obstructive, Noncommunicating Hydrocephalus. | 594 | ||
| Normal-Pressure Hydrocephalus. | 594 | ||
| Chiari Malformation. | 596 | ||
| Idiopathic Intracranial Hypertension (Pseudotumor Cerebri). | 598 | ||
| Intracranial Hypotension. | 598 | ||
| Orbital Lesions | 597 | ||
| Ocular Tumors. | 598 | ||
| Optic Nerve Tumors. | 598 | ||
| Thyroid Ophthalmopathy. | 598 | ||
| Optic Neuritis. | 598 | ||
| Orbital Pseudotumor. | 600 | ||
| Spinal Diseases | 597 | ||
| Spinal Tumors | 597 | ||
| Vertebral Metastases, Extradural Tumors. | 597 | ||
| Extramedullary Intradural Spinal Tumors. | 601 | ||
| Leptomeningeal Metastases. | 601 | ||
| Spinal Meningiomas. | 601 | ||
| Nerve Sheath Tumors. | 602 | ||
| Embryonal Tumors. | 602 | ||
| Intramedullary Tumors. | 601 | ||
| Ependymoma. | 601 | ||
| Astrocytoma. | 601 | ||
| Intramedullary Metastases. | 603 | ||
| Vascular Disease | 603 | ||
| Spinal Cord Infarction. | 604 | ||
| Arteriovenous Malformation. | 604 | ||
| Dural Arteriovenous Fistula. | 604 | ||
| Cavernous Malformation. | 604 | ||
| Infection | 605 | ||
| Discitis and Osteomyelitis. | 605 | ||
| Epidural Abscess, Paravertebral Phlegmon. | 605 | ||
| Noninfectious Inflammatory Disorders | 605 | ||
| Multiple Sclerosis. | 605 | ||
| Acute Disseminated Encephalomyelitis. | 605 | ||
| Transverse Myelitis. | 605 | ||
| Sarcoidosis. | 608 | ||
| Vacuolar Myelopathy. | 608 | ||
| Trauma | 607 | ||
| Hangman’s Fracture. | 608 | ||
| Odontoid Fracture. | 608 | ||
| Burst Fracture. | 608 | ||
| Jefferson Fracture. | 608 | ||
| Facet Joint Disruption, Traumatic Spondylolisthesis. | 609 | ||
| Spinal Epidural Hematoma. | 609 | ||
| Spinal Subdural Hematoma. | 609 | ||
| Spinal Subarachnoid Hemorrhage. | 610 | ||
| Spinal Cord Trauma. | 610 | ||
| Spinal Cord Injury without Radiologic Abnormality. | 611 | ||
| 9780323339162v2_WEB | 1078 | ||
| Front Cover | 1078 | ||
| Half title page | 1079 | ||
| Dedication | 1080 | ||
| Bradley’s Neurology in Clinical Practice | 1081 | ||
| Copyright Page | 1082 | ||
| Table Of Contents | 1083 | ||
| Foreword | 1087 | ||
| Preface | 1088 | ||
| List of Contributors | 1089 | ||
| Video Table of Contents | 1096 | ||
| III Neurological Diseases and Their Treatment | 1101 | ||
| A Principles of Management | 1101 | ||
| 53 Management of Neurological Disease | 1101 | ||
| Chapter Outline | 1101 | ||
| Principles of Neurological Management | 1101 | ||
| Evidence-Based Medicine in Neurology | 1101 | ||
| Goals of Treatment | 1102 | ||
| Arresting an Attack | 1102 | ||
| Slowing Disease Progression | 1102 | ||
| Relieving Symptoms | 1102 | ||
| Circumventing Functional Disability | 1103 | ||
| Principles of Symptom Management | 1103 | ||
| Treatment of Common Neurological Symptoms | 1103 | ||
| Pain | 1103 | ||
| Sensory Loss, Paresthesias, and Burning Pain | 1103 | ||
| Weakness | 1103 | ||
| Ataxia | 1104 | ||
| Slowness of Movement or Abnormal Involuntary Movements | 1104 | ||
| Aphasia and Dysarthria | 1104 | ||
| Respiratory Failure | 1104 | ||
| Ethical Considerations in the Treatment of Respiratory Failure. | 1104 | ||
| Managing Terminal Respiratory Failure. | 1105 | ||
| Memory Impairment and Dementia | 1105 | ||
| Treatment of Secondary Effects of Neurological Disease | 1105 | ||
| Explaining the Prognosis | 1105 | ||
| Palliation and Care of the Terminally Ill Patient | 1106 | ||
| Genetic Counseling | 1106 | ||
| Legal Issues | 1106 | ||
| Implications for Clinical Practice | 1107 | ||
| References | 1107 | ||
| References | 1108 | ||
| 54 Principles of Pain Management | 1109 | ||
| Chapter Outline | 1109 | ||
| Definition and Challenge | 1109 | ||
| Anatomy and Physiology of the Pain Pathways | 1109 | ||
| Central Modulation of Nociception | 1110 | ||
| Opioid Receptors | 1110 | ||
| Neuronal Plasticity and Chronic Pain | 1111 | ||
| Multidisciplinary Approach to Pain Management | 1111 | ||
| Pharmacological Management of Chronic Pain | 1112 | ||
| Nonsteroidal Anti-inflammatory Drugs | 1112 | ||
| Antidepressants | 1112 | ||
| Anticonvulsants | 1114 | ||
| Systemic Local Anesthetic Therapies | 1115 | ||
| Topical Analgesics | 1115 | ||
| Muscle Relaxants | 1115 | ||
| N-Methyl-d-Aspartate Receptor Blockers | 1115 | ||
| Opioid Analgesics | 1116 | ||
| Interventional Pain Management | 1118 | ||
| Greater Occipital Nerve Block | 1118 | ||
| Sphenopalatine Ganglion Block for Headache and Facial Pain | 1118 | ||
| Gasserian Ganglion Lesions for Trigeminal Neuralgia | 1119 | ||
| Stellate Ganglion Block | 1120 | ||
| Epidural Corticosteroid Injection | 1120 | ||
| Lumbar Facet Joint Block | 1121 | ||
| Percutaneous Disk Decompression | 1121 | ||
| Spinal Cord Stimulation | 1122 | ||
| Intrathecal Drug Delivery Systems | 1123 | ||
| Motor Cortex Stimulation | 1123 | ||
| Psychological Therapy in Chronic Pain Management | 1123 | ||
| Rehabilitation in Chronic Pain Management | 1124 | ||
| Common Pain Syndromes | 1124 | ||
| Trigeminal Neuralgia | 1124 | ||
| Low Back Pain | 1125 | ||
| Cervicogenic Headache | 1126 | ||
| Complex Regional Pain Syndrome | 1126 | ||
| Post-Stroke Pain Syndrome | 1128 | ||
| Spinal Cord Injury and Pain | 1128 | ||
| Pain in Multiple Sclerosis | 1129 | ||
| Phantom-Limb Pain and Stump Pain | 1129 | ||
| Summary | 1130 | ||
| References | 1130 | ||
| References | 1131 | ||
| 55 Principles of Neurointensive Care | 1133 | ||
| Chapter Outline | 1133 | ||
| Clinical Assessment of Critically Ill Neurological Patients | 1133 | ||
| Monitoring in the Neurointensive Care Unit | 1134 | ||
| Systemic Monitoring | 1134 | ||
| Brain Monitoring | 1135 | ||
| Global Brain Monitoring Techniques | 1136 | ||
| Intracranial Pressure Monitoring | 1136 | ||
| Jugular Bulb Oximetry | 1137 | ||
| Electroencephalography | 1138 | ||
| Regional/Focal Brain Monitoring Techniques | 1138 | ||
| Regional Cerebral Blood Flow Monitoring | 1138 | ||
| Transcranial Doppler Ultrasonography | 1139 | ||
| Evoked Potentials | 1139 | ||
| Local Cerebral Oxygenation Monitoring Techniques | 1139 | ||
| Microdialysis | 1139 | ||
| Principles of Managing Critically Ill Neurological Patients | 1140 | ||
| Analgesia and Sedation | 1140 | ||
| Airway and Ventilatory Assistance | 1141 | ||
| Pulmonary Complications | 1143 | ||
| Cardiovascular Care and Blood Pressure Management | 1143 | ||
| Acute Coronary Syndrome | 1143 | ||
| Cardiac Arrhythmias | 1144 | ||
| Congestive Heart Failure | 1144 | ||
| Blood Pressure Management | 1144 | ||
| Acute Ischemic Stroke. | 1145 | ||
| Intracerebral Hemorrhage. | 1145 | ||
| Subarachnoid Hemorrhage. | 1145 | ||
| Traumatic Brain Injury. | 1145 | ||
| Fluid and Electrolytes | 1145 | ||
| Nutrition and Metabolic Derangements | 1146 | ||
| Fever and Infections | 1147 | ||
| Hematological Complications | 1148 | ||
| References | 1148 | ||
| References | 1149 | ||
| 56 Principles of Neurointerventional Therapy | 1152 | ||
| Chapter Outline | 1152 | ||
| Ischemic Stroke | 1152 | ||
| Acute Stroke Treatment | 1152 | ||
| Sonothrombolysis | 1152 | ||
| Endovascular Revascularization Therapy | 1152 | ||
| Intra-arterial Thrombolysis | 1153 | ||
| Mechanical Recanalization | 1153 | ||
| MR CLEAN, ESCAPE, EXTEND-IA, and SWIFT-PRIME Trials | 1155 | ||
| Angioplasty and Stenting | 1156 | ||
| Carotid Artery Disease | 1157 | ||
| Carotid Artery Angioplasty and Stenting | 1157 | ||
| Angioplasty and Stenting Procedure. | 1157 | ||
| Clinical Trials. | 1157 | ||
| Intracranial Atherosclerotic Disease | 1159 | ||
| Intracranial Angioplasty | 1159 | ||
| Intracranial Angioplasty and Stenting | 1159 | ||
| Angioplasty/Stenting Procedure. | 1160 | ||
| Clinical Trials. | 1160 | ||
| Vertebral Artery Disease | 1161 | ||
| Hemorrhagic Stroke | 1162 | ||
| Cerebral Aneurysms | 1162 | ||
| Ruptured Aneurysms | 1162 | ||
| Unruptured Aneurysms | 1163 | ||
| Endovascular Treatment Modalities | 1163 | ||
| Coil Embolization. | 1163 | ||
| Balloon Remodeling. | 1164 | ||
| Stent-Assisted Coil Embolization. | 1164 | ||
| Alternative Treatments | 1167 | ||
| Management of Cerebral Vasospasm | 1168 | ||
| Balloon Angioplasty | 1168 | ||
| Intra-arterial Vasodilators | 1168 | ||
| Cerebral Arteriovenous Malformations | 1169 | ||
| Embolization Procedure | 1169 | ||
| Polyvinyl Alcohol | 1169 | ||
| n-Butyl Cyanoacrylate | 1170 | ||
| Ethylene Vinyl Alcohol Copolymer | 1170 | ||
| Stereotactic Radiotherapy | 1171 | ||
| Cerebral Arteriovenous Fistulas | 1171 | ||
| Cranial Dural Arteriovenous Fistulas | 1171 | ||
| Carotid-Cavernous Fistulas | 1172 | ||
| Spinal Vascular Malformations | 1173 | ||
| Spinal Dural Arteriovenous Fistula (Type I) | 1174 | ||
| Glomus Arteriovenous Malformation (Type II) | 1174 | ||
| Juvenile/Metameric Arteriovenous Malformation (Type III) | 1174 | ||
| Perimedullary Arteriovenous Malformation (Type IV) | 1174 | ||
| Tumor Embolization | 1174 | ||
| Embolization Procedure | 1175 | ||
| Embolization Materials | 1175 | ||
| Vessel Selection | 1176 | ||
| Clinical Evidence | 1176 | ||
| Idiopathic Intracranial Hypertension | 1176 | ||
| References | 1177 | ||
| References | 1178 | ||
| 57 Neurological Rehabilitation | 1184 | ||
| Chapter Outline | 1184 | ||
| Goals and Structure of Rehabilitation | 1184 | ||
| Aims | 1184 | ||
| Personnel and Strategies | 1185 | ||
| Physicians | 1185 | ||
| Rehabilitation Nursing | 1185 | ||
| Physical Therapists | 1186 | ||
| Exercise and Compensatory Functional Training. | 1186 | ||
| Conditioning and Strengthening. | 1186 | ||
| Neurophysiological Schools. | 1186 | ||
| Motor Learning Approaches. | 1187 | ||
| Task-Oriented Practice. | 1187 | ||
| Assistive Equipment. | 1187 | ||
| Occupational Therapists | 1187 | ||
| Speech and Cognitive Therapists | 1188 | ||
| Recreational Therapists | 1189 | ||
| Psychologists | 1189 | ||
| Social Workers | 1189 | ||
| Orthotists and Bracing | 1189 | ||
| Measurement Tools | 1190 | ||
| Organization of Services | 1191 | ||
| Service Provision | 1191 | ||
| Inpatient Rehabilitation Unit. | 1191 | ||
| Community-Based Services. | 1192 | ||
| Biological Bases for Rehabilitative Interventions | 1192 | ||
| Neuromedical Problems during Rehabilitation | 1193 | ||
| Frequency of Complications | 1193 | ||
| Complications in Patients with Stroke | 1193 | ||
| Complications in Patients with Spinal Cord Injury | 1193 | ||
| Complications in Patients with Traumatic Brain Injury | 1194 | ||
| Management of Neuromedical Problems | 1194 | ||
| Dysphagia | 1194 | ||
| Skin Ulcers | 1195 | ||
| Contractures | 1195 | ||
| Heterotopic ossification | 1195 | ||
| Dysautonomia | 1195 | ||
| Bowel and Bladder Dysfunction | 1196 | ||
| Fatigue | 1197 | ||
| Central Pain | 1197 | ||
| Sleep Disorders | 1197 | ||
| Spasticity and Upper Motor Neuron Syndrome | 1197 | ||
| Mechanisms. | 1197 | ||
| Assessments. | 1197 | ||
| Treatment. | 1198 | ||
| Physical Modalities. | 1198 | ||
| Pharmacotherapy. | 1198 | ||
| Chemical Injections. | 1199 | ||
| Surgical Interventions. | 1199 | ||
| Therapies for Impairments and Disabilities | 1199 | ||
| Gait Training | 1199 | ||
| Constraint-Induced Upper Extremity Therapy | 1201 | ||
| Bimanual Upper Extremity Therapy | 1201 | ||
| Virtual Reality Training | 1201 | ||
| Mirror Therapy and Imagery | 1202 | ||
| Instrumented Biofeedback | 1202 | ||
| Acupuncture | 1202 | ||
| Visual Field Deficits | 1202 | ||
| Mechanical and Robotic-Assistive Devices | 1202 | ||
| Upper Extremities | 1202 | ||
| Mobility | 1202 | ||
| Functional Neuromuscular Stimulation | 1203 | ||
| Brain Stimulation | 1203 | ||
| Neural Prostheses and Brain–Computer Interfaces | 1204 | ||
| Pharmacological Adjuncts | 1204 | ||
| Mobile Health and Wireless Sensing Devices | 1204 | ||
| Therapies for Cognitive and Behavioral Disabilities | 1204 | ||
| Overview of Cognitive Therapy | 1204 | ||
| Aphasia | 1205 | ||
| Treatments | 1205 | ||
| Pharmacological Adjuncts | 1206 | ||
| Outcomes | 1206 | ||
| Apraxia | 1206 | ||
| Attentional Disorders | 1206 | ||
| Memory Disturbances | 1207 | ||
| Frequency of Memory Disturbance across Diseases | 1207 | ||
| Treatments | 1207 | ||
| Pharmacological Adjuncts | 1207 | ||
| Outcomes | 1208 | ||
| Hemineglect | 1208 | ||
| Frequency | 1208 | ||
| Treatments | 1209 | ||
| Behavioral Disorders | 1209 | ||
| Affective Disorders | 1210 | ||
| Incidence | 1210 | ||
| Treatment | 1210 | ||
| Functional Outcomes with Rehabilitation | 1210 | ||
| Stroke | 1210 | ||
| Ambulation | 1211 | ||
| Self-Care Skills | 1211 | ||
| Spinal Cord Injury | 1211 | ||
| Traumatic Brain Injury | 1212 | ||
| Parkinson Disease | 1212 | ||
| Multiple Sclerosis | 1212 | ||
| Other Diseases | 1213 | ||
| Aging with Neurological Disabilities | 1213 | ||
| Future Directions | 1213 | ||
| References | 1213 | ||
| References | 1214 | ||
| B Neurological Complications of Systemic Disease | 1216 | ||
| 58 Neurological Complications of Systemic Disease | 1216 | ||
| Chapter Outline | 1216 | ||
| Cardiac Disorders and the Nervous System | 1217 | ||
| Cardiogenic Embolism | 1217 | ||
| Syncope | 1217 | ||
| Cardiac Arrest | 1218 | ||
| Complications of Cardiac Catheterization and Surgery | 1218 | ||
| Neurological Complications of Medication | 1219 | ||
| Infective Endocarditis | 1219 | ||
| Diseases of the Aorta | 1220 | ||
| Aortic Aneurysms | 1220 | ||
| Aortitis | 1220 | ||
| Coarctation of the Aorta | 1221 | ||
| Subclavian Steal Syndrome | 1221 | ||
| Complications of Aortic Surgery | 1221 | ||
| Connective Tissue Diseases and Vasculitides | 1221 | ||
| Polyarteritis Nodosa, Churg-Strauss Syndrome, and Overlap Syndrome | 1221 | ||
| Giant Cell Arteritis | 1222 | ||
| Granulomatosis with Polyangiitis | 1222 | ||
| Isolated Angiitis of the Nervous System | 1223 | ||
| Rheumatoid Arthritis | 1223 | ||
| Systemic Lupus Erythematosus | 1223 | ||
| Sjögren Syndrome | 1223 | ||
| Progressive Systemic Sclerosis | 1224 | ||
| Behçet Disease | 1224 | ||
| Relapsing Polychondritis | 1224 | ||
| Respiratory Diseases | 1224 | ||
| Hypoxia | 1224 | ||
| Hypercapnia | 1224 | ||
| Hypocapnia | 1224 | ||
| Systemic Inflammatory Response Syndrome | 1224 | ||
| Sarcoidosis | 1225 | ||
| Hematological Disorders with Anemia | 1226 | ||
| Megaloblastic Anemia | 1226 | ||
| Sickle Cell Disease | 1226 | ||
| Thalassemias | 1226 | ||
| Acanthocytic Syndromes | 1226 | ||
| Proliferative Hematological Disorders | 1226 | ||
| Leukemias | 1226 | ||
| Plasma Cell Dyscrasias | 1226 | ||
| Myelomatosis | 1226 | ||
| Waldenström Macroglobulinemia | 1227 | ||
| Monoclonal Gammopathy of Undetermined Significance | 1227 | ||
| Amyloidosis | 1227 | ||
| Cryoglobulinemia | 1227 | ||
| Lymphoma | 1228 | ||
| Polycythemia | 1228 | ||
| Hemorrhagic Diseases | 1228 | ||
| Hemophilia | 1228 | ||
| Other Hemorrhagic Disorders | 1228 | ||
| Disseminated Intravascular Coagulation | 1228 | ||
| Thrombocytopenia | 1228 | ||
| Thrombotic Thrombocytopenic Purpura | 1228 | ||
| Iatrogenic Hemorrhagic Disorders | 1228 | ||
| Antiphospholipid Antibody Syndromes | 1229 | ||
| Liver Disease | 1229 | ||
| Portal-Systemic Encephalopathy | 1229 | ||
| Chronic NonWilsonian Hepatocerebral Degeneration | 1229 | ||
| Liver Transplantation | 1230 | ||
| Pancreatic Encephalopathy | 1230 | ||
| Gastrointestinal Diseases | 1230 | ||
| Gastric Surgery | 1230 | ||
| Small-Bowel Disease | 1230 | ||
| Celiac Disease | 1230 | ||
| Whipple Disease | 1230 | ||
| Renal Failure | 1231 | ||
| Overview of Related Neurological Complications | 1231 | ||
| Neurological Complications of Dialysis | 1231 | ||
| Neurological Complications of Renal Transplantation | 1232 | ||
| Electrolyte Disturbances | 1232 | ||
| Sodium | 1232 | ||
| Potassium | 1232 | ||
| Calcium | 1232 | ||
| Magnesium | 1233 | ||
| Pituitary Disease | 1233 | ||
| Pituitary Adenomas | 1233 | ||
| Cushing Disease and Syndrome | 1233 | ||
| Hypopituitarism | 1234 | ||
| Diabetes Insipidus | 1234 | ||
| Thyroid Disease | 1234 | ||
| Hyperthyroidism | 1234 | ||
| Hypothyroidism | 1234 | ||
| Hashimoto Thyroiditis | 1234 | ||
| Parathyroid Disease | 1235 | ||
| Hyperparathyroidism | 1235 | ||
| Hypoparathyroidism | 1235 | ||
| Adrenal Glands | 1235 | ||
| Pheochromocytoma | 1235 | ||
| Addison Disease | 1235 | ||
| Diabetes Mellitus | 1235 | ||
| Peripheral Nervous System | 1235 | ||
| Central Nervous System | 1235 | ||
| Hypoglycemia | 1236 | ||
| References | 1236 | ||
| References | 1237 | ||
| 59 Neurological Complications of Systemic Disease: | 1238 | ||
| Chapter Outline | 1238 | ||
| Cardiac Disorders and the Nervous System | 1238 | ||
| Congenital Heart Disease | 1238 | ||
| Cerebral Dysgenesis and Malformations | 1238 | ||
| Chromosomal and Genetic Disorders | 1238 | ||
| Neurological Complications Unrelated to Intervention and Cardiac Surgery | 1239 | ||
| Cerebrovascular Accidents in Uncorrected Congenital Heart Disease | 1239 | ||
| Brain Abscess | 1239 | ||
| Infective Endocarditis | 1239 | ||
| Cognitive Impairment | 1239 | ||
| Neurological Complications of Intervention and Cardiac Surgery | 1240 | ||
| Cardiac Transplantation | 1240 | ||
| Acquired Heart Disease | 1241 | ||
| Connective Tissue Diseases and Vasculitides | 1241 | ||
| Polyarteritis Nodosa | 1241 | ||
| Kawasaki Disease | 1241 | ||
| Henoch-Schönlein Purpura | 1242 | ||
| Takayasu Arteritis | 1242 | ||
| Churg-Strauss Syndrome | 1242 | ||
| Juvenile Rheumatoid Arthritis | 1242 | ||
| Systemic Lupus Erythematosus | 1242 | ||
| Granulomatosis with Polyangiitis (Wegener) | 1243 | ||
| Behçet Disease | 1244 | ||
| Sjögren Syndrome | 1244 | ||
| Primary Angiitis of the Central Nervous System | 1244 | ||
| Respiratory Disorders | 1244 | ||
| Periodic Breathing and Apnea | 1244 | ||
| Bronchopulmonary Dysplasia | 1244 | ||
| Cystic Fibrosis | 1245 | ||
| Sarcoidosis | 1245 | ||
| Hypertension | 1245 | ||
| Hematological Disorders | 1246 | ||
| Hemolytic Disease of the Newborn and Kernicterus | 1246 | ||
| Hemorrhagic Disease of the Newborn | 1246 | ||
| Neonatal Polycythemia | 1246 | ||
| Sickle Cell Disease | 1246 | ||
| Hemophilia | 1247 | ||
| Thrombotic Thrombocytopenic Purpura | 1247 | ||
| Hemolytic-Uremic Syndrome | 1248 | ||
| Gastrointestinal Disorders | 1248 | ||
| Hepatic Encephalopathy | 1248 | ||
| Liver Transplantation | 1248 | ||
| Endocrine Disorders | 1249 | ||
| Thyroid Disorders | 1249 | ||
| Hypothyroidism | 1249 | ||
| Hyperthyroidism | 1249 | ||
| Parathyroid Disorders | 1249 | ||
| Adrenal Gland Dysfunction | 1250 | ||
| Addison Disease | 1250 | ||
| Cushing Syndrome | 1250 | ||
| Excess Mineralocorticoid Secretion | 1250 | ||
| Pituitary Disorders | 1250 | ||
| Diabetes Mellitus | 1250 | ||
| Renal Disorders | 1251 | ||
| Renal Failure | 1251 | ||
| Complications of Dialysis | 1251 | ||
| Headaches | 1251 | ||
| Dialysis Disequilibrium Syndrome | 1251 | ||
| Progressive Dialysis Dementia | 1251 | ||
| Renal Transplantation | 1251 | ||
| References | 1252 | ||
| References | 1253 | ||
| C Trauma of the Nervous System | 1255 | ||
| 60 Basic Neuroscience of Neurotrauma | 1255 | ||
| Chapter Outline | 1255 | ||
| Experimental Models of Traumatic Brain Injury | 1255 | ||
| Percussion Concussion | 1255 | ||
| Acceleration Concussion | 1256 | ||
| Military Models | 1256 | ||
| In Vitro Models | 1256 | ||
| Neuronal Damage after Traumatic Brain Injury | 1256 | ||
| Temporal Patterns of Neuronal Death | 1256 | ||
| Selective Neuronal Vulnerability | 1257 | ||
| Progressive Damage | 1257 | ||
| Secondary and Repetitive Damage | 1258 | ||
| Axonal and Dendritic Injury | 1258 | ||
| Importance of Gender | 1259 | ||
| Basic Mechanisms of Injury | 1260 | ||
| Primary Injury Mechanisms | 1260 | ||
| Secondary Injury Mechanisms | 1260 | ||
| Therapeutic Interventions Directed Against Pathophysiological Processes | 1261 | ||
| Glutamate Antagonists | 1261 | ||
| Free Radical Scavengers | 1261 | ||
| Neurotrophic Factors | 1261 | ||
| Protection by Nitric Oxide-Related Species | 1261 | ||
| Inflammation | 1262 | ||
| Antiapoptotic Agents | 1262 | ||
| Therapeutic Hypothermia | 1262 | ||
| Recovery of Function | 1263 | ||
| Environmental Enrichment | 1263 | ||
| Reparative and Transplantation Strategies | 1263 | ||
| Summary and Future Directions | 1264 | ||
| References | 1264 | ||
| References | 1265 | ||
| 61 Sports and Performance Concussion | 1266 | ||
| Chapter Outline | 1266 | ||
| Epidemiology | 1266 | ||
| Definition | 1266 | ||
| Pathophysiology | 1266 | ||
| Neurometabolic Cascade | 1266 | ||
| Cerebral Blood Flow | 1267 | ||
| Axonal Dysfunction | 1267 | ||
| Synaptic Plasticity and Neural Activation | 1267 | ||
| Diagnosis | 1267 | ||
| In-Office/Outpatient Evaluation | 1268 | ||
| Neuropsychological Testing | 1268 | ||
| Neuroimaging | 1268 | ||
| Acute and Subacute Management | 1268 | ||
| Return to School, Work, or Cognitive Activity | 1269 | ||
| Return to Physical Activity | 1269 | ||
| Risk Involved with Premature Return to Participation | 1270 | ||
| Long-Term Effects | 1270 | ||
| Post-Concussion Syndrome (PCS) | 1270 | ||
| Chronic Traumatic Encephalopathy | 1271 | ||
| When to Retire an Athlete | 1271 | ||
| Prevention | 1272 | ||
| References | 1272 | ||
| References | 1273 | ||
| 62 Craniocerebral Trauma | 1275 | ||
| Chapter Outline | 1275 | ||
| Epidemiology | 1275 | ||
| Classification | 1275 | ||
| Mechanism | 1275 | ||
| Injury Severity | 1276 | ||
| Morphology | 1277 | ||
| Skull Fractures | 1277 | ||
| Intracranial Injuries | 1277 | ||
| Pathophysiolgy | 1280 | ||
| Treatment | 1281 | ||
| Evaluation | 1281 | ||
| Management of Diffuse Injuries | 1281 | ||
| Management of Focal Injuries | 1286 | ||
| Late Complications | 1287 | ||
| Outcome | 1287 | ||
| Future of TBI | 1288 | ||
| References | 1288 | ||
| References | 1289 | ||
| 63 Spinal Cord Trauma | 1291 | ||
| Chapter Outline | 1291 | ||
| Epidemiology | 1291 | ||
| Pathophysiology | 1291 | ||
| Clinical Presentation | 1293 | ||
| Spinal Cord Injury Syndromes | 1293 | ||
| Central Cord Syndrome | 1293 | ||
| Anterior Cord Syndrome | 1294 | ||
| Posterior Column Syndrome | 1294 | ||
| Brown–Séquard Syndrome | 1294 | ||
| Cervicomedullary Syndrome | 1295 | ||
| Conus Medullaris Syndrome | 1295 | ||
| Cauda Equina Syndrome | 1296 | ||
| Transient Spinal Cord Syndromes | 1296 | ||
| Spinal Shock | 1296 | ||
| Mechanisms and Types of Injuries | 1297 | ||
| Cervical Spine Fractures | 1297 | ||
| Atlanto-occipital Dissociation | 1297 | ||
| Occipital Condyle Fractures | 1297 | ||
| Atlantoaxial Injuries | 1297 | ||
| Subaxial Cervical Spine Injuries | 1298 | ||
| Thoracolumbar Injuries | 1299 | ||
| Penetrating Spinal Cord Injuries | 1299 | ||
| Management of Acute Spinal Cord Injuries | 1299 | ||
| Management in the Field | 1299 | ||
| Initial Hospital Assessment | 1300 | ||
| Radiographic Evaluation | 1300 | ||
| Current Guidelines | 1300 | ||
| Plain Radiography | 1300 | ||
| Computed Tomography | 1301 | ||
| Magnetic Resonance Imaging | 1301 | ||
| SCIWORA | 1301 | ||
| Treatment of Spinal Cord Injuries in the Acute Setting | 1301 | ||
| Cardiovascular Management in the Intensive Care Unit Setting | 1301 | ||
| Respiratory Management in the Intensive Care Unit Setting | 1302 | ||
| Medical Management | 1303 | ||
| Nutritional Support | 1304 | ||
| Stabilization and Support | 1304 | ||
| Nonsurgical Management | 1304 | ||
| Surgical Management | 1305 | ||
| Long-Term Management of Spinal Cord Injuries | 1306 | ||
| Spinal Cord Injury and Bladder Function | 1306 | ||
| Spinal Cord Injury and Bowel Function | 1308 | ||
| Delayed Post-traumatic Spinal Cord Syndromes | 1309 | ||
| Post-traumatic Syringomyelia | 1309 | ||
| Neuropathic Pain | 1309 | ||
| Spasticity | 1310 | ||
| Autonomic Dysreflexia | 1311 | ||
| Deep Vein Thrombosis and Thromboembolism in Spinal Cord Injury | 1312 | ||
| Future Directions | 1312 | ||
| References | 1313 | ||
| References | 1314 | ||
| 64 Trauma of the Nervous System: Peripheral Nerve Trauma | 1317 | ||
| Chapter Outline | 1317 | ||
| Anatomy of the Spinal Nerves of the Peripheral Nervous System | 1317 | ||
| Axon | 1317 | ||
| Peripheral Nerve Trunks | 1318 | ||
| Classification of Nerve Trauma | 1319 | ||
| Peripheral Nerve Degeneration and Regeneration | 1319 | ||
| Segmental Demyelination | 1319 | ||
| Wallerian Degeneration | 1320 | ||
| Distal Segment Changes | 1320 | ||
| Proximal Segment | 1320 | ||
| Nerve Regeneration | 1320 | ||
| Mechanisms of Traumatic Nerve Injury | 1321 | ||
| Compression | 1321 | ||
| Stretch and Traction | 1321 | ||
| Laceration | 1322 | ||
| Crush | 1322 | ||
| Gunshot | 1322 | ||
| Radiation | 1322 | ||
| Cold Injury | 1322 | ||
| Electrical | 1323 | ||
| Injection | 1323 | ||
| Evaluation of Nerve Trauma | 1323 | ||
| Clinical and Electrodiagnostic Examination | 1323 | ||
| Imaging Studies | 1324 | ||
| Surgical Repair of Nerve Trauma | 1325 | ||
| Indications for and Timing of Surgical Repair | 1325 | ||
| Intraoperative Nerve Monitoring | 1327 | ||
| Surgical Techniques | 1328 | ||
| Neurolysis (External and Internal) | 1328 | ||
| Primary Neurorrhaphy | 1328 | ||
| Nerve Grafting | 1329 | ||
| Nerve Transfer | 1330 | ||
| Management of Neuropathic Pain Associated with Nerve Trauma | 1331 | ||
| Pharmacological Options | 1331 | ||
| Interventional Strategies | 1331 | ||
| Movement Disorders after Nerve Trauma | 1331 | ||
| Future Directions in Treatment of Nerve Trauma | 1333 | ||
| References | 1333 | ||
| References | 1334 | ||
| D Vascular Diseases of the Nervous System | 1336 | ||
| 65 Ischemic Cerebrovascular Disease | 1336 | ||
| Chapter Outline | 1336 | ||
| Epidemiology and Risk Factors | 1336 | ||
| Risk Factors for Stroke | 1337 | ||
| Heredity and Risk of Stroke | 1337 | ||
| Common Modifiable Risk Factors | 1337 | ||
| Other Risk Factors for Stroke | 1340 | ||
| Pathophysiology of Cerebral Ischemia | 1340 | ||
| Pathology of Ischemic Stroke | 1341 | ||
| Clinical Syndromes of Cerebral Ischemia | 1341 | ||
| Transient Ischemic Attacks | 1341 | ||
| Carotid Artery System Syndromes | 1343 | ||
| Carotid Artery Syndromes | 1343 | ||
| Middle Cerebral Artery Syndromes | 1343 | ||
| Syndromes of the Anterior Cerebral Artery and Related Blood Vessels | 1344 | ||
| Lacunar Syndromes | 1344 | ||
| Vertebrobasilar System Syndromes | 1345 | ||
| Posterior Cerebral Artery Syndromes | 1346 | ||
| Syndromes of Thalamic Infarction | 1348 | ||
| Watershed Ischemic Syndromes | 1348 | ||
| Diagnosis and Treatment of Threatened Ischemic Stroke | 1348 | ||
| Large-Artery Atherothrombotic Infarctions | 1350 | ||
| Small-Vessel or Penetrating Artery Disease | 1351 | ||
| Cardiogenic Embolism | 1351 | ||
| Nonatherosclerotic Vasculopathies | 1354 | ||
| Dissections | 1354 | ||
| Trauma | 1356 | ||
| Radiation Vasculopathy | 1356 | ||
| Moyamoya | 1356 | ||
| Fibromuscular Dysplasia | 1358 | ||
| Inflammatory Vasculitides | 1358 | ||
| Infections and Stroke | 1359 | ||
| Drug Abuse and Stroke | 1359 | ||
| Stroke and Systemic Vasculitides | 1360 | ||
| Migraine and Stroke | 1362 | ||
| Inherited and Miscellaneous Disorders | 1363 | ||
| Hypercoagulable Disorders | 1365 | ||
| Primary Hypercoagulable States | 1365 | ||
| Secondary Hypercoagulable States | 1367 | ||
| Sickle Cell Disease | 1370 | ||
| Thrombotic Thrombocytopenic Purpura | 1370 | ||
| Infarcts of Undetermined Cause | 1370 | ||
| Essential Investigations for Patients with Threatened Strokes | 1370 | ||
| Neuroimaging | 1371 | ||
| Cardiac Evaluation of the Stroke Patient | 1372 | ||
| Cerebral Angiography | 1373 | ||
| Preventing Stroke Recurrence: Medical Therapy | 1374 | ||
| Platelet Antiaggregants | 1374 | ||
| Oral Anticoagulants | 1375 | ||
| Treatment of Acute Ischemic Stroke | 1377 | ||
| Heparins and Heparinoids | 1377 | ||
| Thrombolytic Therapy | 1377 | ||
| Defibrinogenating and Hemorheological Agents | 1382 | ||
| Neuroprotective Agents | 1382 | ||
| Hypothermia | 1383 | ||
| Surgical Therapy | 1382 | ||
| Symptomatic Carotid Artery Stenosis | 1382 | ||
| Asymptomatic Carotid Artery Stenosis | 1384 | ||
| Stenting of the Carotid Artery and Other Cervicocerebral Vessels | 1385 | ||
| General Management of Acute Ischemic Stroke | 1386 | ||
| Cerebral Venous Thrombosis | 1388 | ||
| References | 1393 | ||
| References | 1394 | ||
| 66 Intracerebral Hemorrhage | 1399 | ||
| Chapter Outline | 1399 | ||
| Mechanisms of Intracerebral Hemorrhage | 1399 | ||
| Hypertension | 1399 | ||
| Vascular Malformations | 1399 | ||
| Intracranial Tumors | 1400 | ||
| Bleeding Disorders, Anticoagulants, and Fibrinolytic Treatment | 1400 | ||
| Cerebral Amyloid Angiopathy | 1402 | ||
| Granulomatous Angiitis of the Central Nervous System and Other Vasculitides | 1403 | ||
| Sympathomimetic Agents | 1405 | ||
| Hemorrhagic Infarction | 1406 | ||
| Head Trauma | 1406 | ||
| Clinical Features of Intracerebral Hemorrhage | 1406 | ||
| Putaminal Hemorrhage | 1407 | ||
| Caudate Hemorrhage | 1409 | ||
| Thalamic Hemorrhage | 1409 | ||
| Lobar Hemorrhage | 1409 | ||
| Cerebellar Hemorrhage | 1412 | ||
| Pontine Hemorrhage | 1412 | ||
| Mesencephalic Hemorrhage | 1412 | ||
| Medullary Hemorrhage | 1414 | ||
| Intraventricular Hemorrhage | 1414 | ||
| Treatment of Intracerebral Hemorrhage | 1414 | ||
| General Management of Intracerebral Hemorrhage | 1414 | ||
| Initial Evaluation | 1414 | ||
| General Measures for Prevention of Further Elevation of Intracranial Pressure | 1416 | ||
| Specific Treatment of Increased Intracranial Pressure | 1416 | ||
| Choice between Medical and Surgical Therapy in Intracerebral Hemorrhage | 1416 | ||
| Hemostatic Therapy of Intracerebral Hemorrhage | 1417 | ||
| References | 1417 | ||
| References | 1419 | ||
| 67 Intracranial Aneurysms and Subarachnoid Hemorrhage | 1421 | ||
| Chapter Outline | 1421 | ||
| Epidemiology | 1421 | ||
| Associated Conditions | 1421 | ||
| Pathophysiology | 1422 | ||
| Saccular Aneurysm | 1422 | ||
| Fusiform Aneurysm | 1423 | ||
| Dissecting Aneurysm | 1423 | ||
| Natural History of Intracranial Aneurysms | 1423 | ||
| Imaging Modalities and Diagnosis | 1425 | ||
| Subarachnoid Hemorrhage | 1425 | ||
| Symptoms | 1428 | ||
| Treatment of Incidental Intracranial Aneurysms | 1428 | ||
| Open Surgical Treatment | 1429 | ||
| Endovascular Treatment | 1429 | ||
| Management of Subarachnoid Hemorrhage | 1431 | ||
| Endovascular and Surgical Treatment of Ruptured Aneurysms | 1431 | ||
| Vasospasm and Delayed Cerebral Ischemia | 1432 | ||
| References | 1433 | ||
| References | 1434 | ||
| 68 Stroke in Children | 1436 | ||
| Chapter Outline | 1436 | ||
| Stroke and the Developing Cerebrovascular System | 1436 | ||
| Epidemiology | 1436 | ||
| Full-Term and Near-Term Neonates | 1436 | ||
| The General Population of Children | 1436 | ||
| High-Risk Subgroups | 1436 | ||
| Presentations | 1438 | ||
| Etiology | 1439 | ||
| Cardiac | 1439 | ||
| Hematological | 1439 | ||
| Trauma and Vascular Compression | 1439 | ||
| Infection | 1440 | ||
| Vascular Malformations/Vasculopathy/Migraine | 1440 | ||
| Drugs/Toxins | 1440 | ||
| Metabolic | 1441 | ||
| Gender and Ethnicity | 1441 | ||
| Genetic | 1441 | ||
| Differential Diagnosis | 1442 | ||
| Evaluation | 1442 | ||
| History and Physical | 1442 | ||
| Imaging Studies | 1444 | ||
| Coagulation Workup | 1444 | ||
| Cardiac Evaluation | 1444 | ||
| Other Studies | 1445 | ||
| Treatment | 1445 | ||
| The Acute Period and Initiating Chronic Therapy | 1445 | ||
| Additional Issues in Chronic Therapy | 1445 | ||
| Other Issues | 1446 | ||
| Summary | 1446 | ||
| References | 1446 | ||
| References | 1447 | ||
| 69 Spinal Cord Vascular Disease | 1450 | ||
| Chapter Outline | 1450 | ||
| Vascular Anatomy of the Spinal Cord | 1450 | ||
| Vascular Anatomy of the Spinal Cord | 1451 | ||
| Intrinsic Spinal Cord Arterial Supply | 1451 | ||
| Venous Drainage | 1451 | ||
| Spinal Cord Infarction | 1450 | ||
| Presentation and Initial Course | 1450 | ||
| Examination Findings | 1450 | ||
| Investigations | 1450 | ||
| Course and Prognosis | 1453 | ||
| Causes of Spinal Cord Infarction | 1454 | ||
| Treatment | 1455 | ||
| Spinal Vascular Malformations | 1455 | ||
| Distribution and Prevalence | 1455 | ||
| Clinical Presentation and Course | 1455 | ||
| Investigations | 1456 | ||
| Treatment | 1457 | ||
| Spinal Cavernous Malformation | 1458 | ||
| Spinal Hemorrhage | 1458 | ||
| Subarachnoid Hemorrhage | 1458 | ||
| Hematomyelia | 1458 | ||
| Spinal Epidural and Subdural Hemorrhage | 1458 | ||
| References | 1459 | ||
| References | 1460 | ||
| 70 Central Nervous System Vasculitis | 1461 | ||
| Chapter Outline | 1461 | ||
| Types of Central Nervous System Vasculitis | 1461 | ||
| Isolated Central Nervous System Vasculitis | 1461 | ||
| Clinical Findings | 1461 | ||
| Pathology | 1461 | ||
| Laboratory Findings | 1462 | ||
| Approach to Diagnosis | 1462 | ||
| Therapy | 1462 | ||
| Central Nervous System Vasculitis Associated with Other Disorders | 1463 | ||
| Cutaneous Herpes Zoster Infection | 1463 | ||
| Drug Abuse | 1463 | ||
| Lymphoma | 1463 | ||
| Amyloid | 1463 | ||
| References | 1463 | ||
| References | 1464 | ||
| E Cancer and the Nervous System | 1465 | ||
| 71 Epidemiology of Brain Tumors | 1465 | ||
| Chapter Outline | 1465 | ||
| Classification | 1465 | ||
| Descriptive Epidemiology | 1465 | ||
| Incidence | 1465 | ||
| Mortality and Prognostic Factors | 1466 | ||
| Gender and Race | 1466 | ||
| Temporal Trends | 1467 | ||
| Geographical Trends and Migrant Studies | 1467 | ||
| Primary Central Nervous System Lymphoma | 1467 | ||
| Analytical Epidemiology | 1467 | ||
| Study Designs | 1467 | ||
| Methodological Challenges | 1468 | ||
| Radiation | 1468 | ||
| Ionizing Radiation | 1468 | ||
| Electromagnetic Field Radiation | 1468 | ||
| Radiofrequency and Cellular Telephone | 1468 | ||
| Occupational Studies | 1469 | ||
| Head Trauma | 1469 | ||
| N-Nitroso Compounds | 1469 | ||
| Vitamins | 1470 | ||
| Tobacco and Alcohol | 1470 | ||
| Tea and Coffee | 1470 | ||
| Infections, Allergies and Immunity | 1470 | ||
| Genetic Syndromes | 1471 | ||
| Genetic Susceptibility | 1472 | ||
| Summary | 1472 | ||
| References | 1472 | ||
| References | 1473 | ||
| 72 Pathology and Molecular Genetics | 1475 | ||
| Chapter Outline | 1475 | ||
| General Principles of Nervous System Tumor Biology | 1475 | ||
| History of Nervous System Tumor Classification Schemes | 1475 | ||
| General Histopathological Features and Techniques | 1476 | ||
| General Histopathological Features | 1476 | ||
| Anaplasia | 1477 | ||
| Tumor Grading | 1477 | ||
| Palisading | 1477 | ||
| Rosettes | 1477 | ||
| Desmoplasia | 1477 | ||
| Microvascular Proliferation | 1477 | ||
| Frozen Sections and Touch Imprints/Smears | 1477 | ||
| Electron Microscopy (Ultrastructural Pathology) | 1478 | ||
| Immunohistochemistry | 1478 | ||
| Glial Markers | 1478 | ||
| Neuronal Markers | 1478 | ||
| Epithelial Markers | 1479 | ||
| S100 Protein | 1479 | ||
| Other Useful Immunomarkers | 1479 | ||
| Methods of Assessing Cell Proliferation | 1479 | ||
| Molecular Diagnostics | 1479 | ||
| Primary Neuroepithelial Tumors | 1479 | ||
| Diffuse Astrocytoma (WHO Grade II–III) | 1480 | ||
| Oligodendroglioma (WHO Grade II–III) | 1480 | ||
| Oligoastrocytoma (WHO Grade II–III) | 1481 | ||
| Glioblastoma (WHO Grade IV) | 1481 | ||
| Molecular Characteristics of Diffuse Gliomas | 1481 | ||
| Circumscribed (“Favorable Prognosis”) Neuroepithelial Tumors | 1482 | ||
| Pilocytic Astrocytoma (WHO Grade I) | 1483 | ||
| Pleomorphic Xanthoastrocytoma (WHO Grade II or III) | 1483 | ||
| Subependymal Giant Cell Astrocytoma (WHO Grade I) | 1483 | ||
| Ganglioglioma/Gangliocytoma (WHO Grade I or II) | 1484 | ||
| Dysembryoplastic Neuroepithelial Tumor (WHO Grade I) | 1484 | ||
| Other Glioneuronal Tumors | 1484 | ||
| Central Neurocytoma (WHO Grade II) | 1485 | ||
| Ependymoma (WHO Grade II or III) | 1485 | ||
| Myxopapillary Ependymoma (WHO Grade I) | 1485 | ||
| Subependymoma (WHO Grade I) | 1486 | ||
| Choroid Plexus Tumors | 1486 | ||
| Choroid Plexus Papilloma (WHO Grade I) | 1486 | ||
| Choroid Plexus Carcinoma (WHO Grade III) | 1486 | ||
| Embryonal Tumors/Primitive Neuroectodermal Tumors | 1487 | ||
| Medulloblastoma (WHO Grade IV) | 1487 | ||
| Atypical Teratoid/Rhabdoid Tumor (WHO Grade IV) | 1488 | ||
| Meningeal/Extra-axial Tumors | 1488 | ||
| Meningioma (WHO Grade I) | 1488 | ||
| Atypical Meningioma (WHO Grade II) | 1488 | ||
| Anaplastic Meningioma (WHO Grade III) | 1489 | ||
| Molecular Features of Meningioma | 1489 | ||
| Hemangiopericytoma and Solitary Fibrous Tumor (WHO Grade II or III) | 1489 | ||
| Nerve Sheath Tumors | 1490 | ||
| Schwannoma (Neurilemoma) (WHO Grade I) | 1490 | ||
| Neurofibroma (WHO Grade I) | 1490 | ||
| Miscellaneous Tumors | 1490 | ||
| Central Nervous System Lymphoma | 1490 | ||
| Germ Cell Tumors | 1491 | ||
| Hemangioblastoma (WHO Grade I) | 1492 | ||
| Craniopharyngioma (WHO Grade I) | 1492 | ||
| Epidermoid and Dermoid Cysts | 1492 | ||
| Neuroenteric, Colloid, and Rathke Cleft Cysts | 1492 | ||
| Lipomas | 1493 | ||
| Metastatic Tumors | 1493 | ||
| Acknowledgments | 1493 | ||
| References | 1493 | ||
| References | 1494 | ||
| 73 Clinical Features of Brain Tumors and Complications of Their Treatment | 1496 | ||
| Chapter Outline | 1496 | ||
| Clinical Features of Brain Tumors | 1496 | ||
| Overview of Symptoms | 1496 | ||
| Specific Symptoms and Signs | 1496 | ||
| Focal Symptoms | 1496 | ||
| Focal Motor Symptoms. | 1496 | ||
| Ataxia. | 1496 | ||
| Aphasia. | 1497 | ||
| Visual Problems. | 1497 | ||
| Seizures. | 1497 | ||
| Generalized Symptoms | 1497 | ||
| Headaches. | 1497 | ||
| Nausea and Vomiting. | 1498 | ||
| Syncope. | 1498 | ||
| Mental Status and Behavioral Changes. | 1498 | ||
| Complications of Brain Tumor Treatment | 1498 | ||
| Surgery | 1498 | ||
| Radiation | 1499 | ||
| Chemotherapy and Biologic Therapy | 1499 | ||
| References | 1499 | ||
| References | 1500 | ||
| 74 Primary Nervous System Tumors in Adults | 1501 | ||
| Chapter Outline | 1501 | ||
| General Aspects | 1501 | ||
| Established Treatment Strategies | 1501 | ||
| Surgery | 1501 | ||
| Radiation Therapy | 1502 | ||
| Conventional Fractionated Radiotherapy. | 1502 | ||
| Brachytherapy. | 1502 | ||
| Sensitization of Tumor Cells to Ionizing Radiation. | 1502 | ||
| Stereotactic Radiosurgery Techniques. | 1502 | ||
| Chemotherapy | 1503 | ||
| Standard Cytotoxic Chemotherapy. | 1503 | ||
| Delivery Strategies. | 1503 | ||
| New Treatment Strategies | 1503 | ||
| Management of Specific Brain Tumors | 1507 | ||
| Neuroepithelial Tumors | 1507 | ||
| Astrocytic Tumors | 1507 | ||
| Noninfiltrative Tumors | 1507 | ||
| Pilocytic Astrocytoma. | 1507 | ||
| Pleomorphic Xanthoastrocytoma. | 1507 | ||
| Subependymal Giant Cell Astrocytoma. | 1508 | ||
| Neuroepithelial Tumors of Unknown Origin: Chordoid Glioma of the Third Ventricle. | 1508 | ||
| Infiltrative Low-Grade Astrocytomas. | 1508 | ||
| High-Grade Astrocytomas | 1509 | ||
| Anaplastic Astrocytoma. | 1509 | ||
| Glioblastoma Multiforme. | 1509 | ||
| Others | 1510 | ||
| Gliomatosis Cerebri. | 1510 | ||
| Oligodendroglial Tumors | 1510 | ||
| Oligodendroglioma and Oligoastrocytoma. | 1510 | ||
| Anaplastic Oligodendroglioma and Anaplastic Oligoastrocytoma. | 1510 | ||
| Ependymal Tumors | 1510 | ||
| Ependymoma and Anaplastic Ependymoma. | 1510 | ||
| Subependymoma. | 1510 | ||
| Choroid Plexus Tumors | 1510 | ||
| Choroid Plexus Papilloma and Carcinoma. | 1510 | ||
| Neuronal and Mixed Neuronal-Glial Tumors | 1511 | ||
| Ganglioglioma and Gangliocytoma. | 1511 | ||
| Central Neurocytoma. | 1511 | ||
| Pineal Parenchymal Tumors | 1511 | ||
| Peripheral Neuroblastic Tumors | 1511 | ||
| Esthesioneuroblastoma. | 1511 | ||
| Embryonal Tumors | 1511 | ||
| Medulloblastoma. | 1511 | ||
| Supratentorial Primitive Neuroectodermal Tumors. | 1512 | ||
| Tumors of Cranial and Peripheral Nerves | 1512 | ||
| Schwannoma and Neurofibroma | 1512 | ||
| Malignant Peripheral Nerve Sheath Tumor | 1513 | ||
| Meningeal Tumors | 1513 | ||
| Meningioma | 1513 | ||
| Hemangiopericytoma | 1514 | ||
| Neuraxis Tumors Derived from the Hematopoietic System | 1514 | ||
| Primary Central Nervous System Lymphoma | 1514 | ||
| NonAIDS Related Disease. | 1514 | ||
| AIDS-Related PCNSL. | 1515 | ||
| Germ Cell Tumors | 1515 | ||
| Germinoma | 1515 | ||
| Nongerminomatous Germ Cell Tumors | 1515 | ||
| Tumors of the Sellar Region | 1515 | ||
| Craniopharyngioma | 1515 | ||
| Pituitary Adenoma | 1516 | ||
| References | 1516 | ||
| References | 1517 | ||
| 75 Primary Nervous System Tumors in Infants and Children | 1520 | ||
| Chapter Outline | 1520 | ||
| Pediatric Primary Nervous System Tumors | 1520 | ||
| Embryonal Tumors | 1520 | ||
| Medulloblastoma and Central Nervous System Primitive Neuroectodermal Tumor | 1520 | ||
| Background | 1520 | ||
| Etiology | 1520 | ||
| Clinical Presentation | 1522 | ||
| Diagnosis | 1522 | ||
| Management | 1522 | ||
| Prognosis | 1524 | ||
| Atypical Teratoid/Rhabdoid Tumor | 1524 | ||
| Background | 1524 | ||
| Clinical Presentation | 1524 | ||
| Diagnosis | 1524 | ||
| Management and Prognosis | 1524 | ||
| Astrocytic Tumors | 1525 | ||
| Pilocytic Astrocytoma | 1525 | ||
| Background | 1525 | ||
| Clinical Presentation | 1525 | ||
| Diagnosis | 1525 | ||
| Management | 1526 | ||
| Prognosis | 1526 | ||
| Optic Pathway Glioma | 1526 | ||
| Background | 1526 | ||
| Clinical Presentation | 1526 | ||
| Diagnosis and Management | 1527 | ||
| Prognosis | 1527 | ||
| Subependymal Giant Cell Astrocytoma | 1527 | ||
| Background | 1527 | ||
| Clinical Presentation | 1527 |