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CHAPTER 1 TRACTS，CELL GROUPS AND BLOOD SUPPLY OF THE SPINAL CORD17

Introduction17

Tracts of the Spinal Cord17

Descending Exogenous Tracts18

Tracts Descending from the Cerebral Cortex18

Tracts Descending from Subcortical Structures19

Ascending Exogenous Tracts21

Short Posterior Root Fibers and Ascending Pathways21

Intermediate Posterior Root Fibers and Ascending Pathways23

Long Posterior Root Fibers and Ascending Pathways24

Intersegmental，or Association，Tracts25

Anterior Root Fibers26

Topography of the Long Spinal Tracts26

Nerve Cell Groups of the Spinal Cord27

Blood Supply of the Spinal Cord29

Arterial Supply29

Venous Return from the Spinal Cord31

CHAPTER 2 SPINAL CORD FUNCTIONS32

Sensory Function of the Spinal Cord32

Superficial，or Exteroceptive，Sensibility32

Deep，or Proprioceptive，Sensibility32

Combined Sensibility33

Impulses from the Periphery Which Do Not Enter Consciousness33

Summary of the Spinal Pathways Conveying Afferent Impulses34

Somatic Motor Function of the Spinal Cord35

Voluntary Movement35

Tonus and Reflexes36

Trophic Function of the Spinal Cord37

Visceral Motor Functions of the Spinal Cord38

Vasomotor Function38

Sudomotor Function42

Pilomotor Function43

CHAPTER 3 THE LOCALIZATION OF SPINAL LESIONS IN THE TRANSVERSE PLANE44

The Localization of Lesions Causing Disturbances of Motility44

The Characteristics of Motor Disturbances Due to Pyramidal Lesions44

The Characteristics of Paralysis Due to Anterior Horn Lesions48

The Manifestations of Lesions Involving Both the Pyramidal Tract and the Anterior Horn50

The Localization of Disturbances of Sensibility51

Localizing Significance of Combined Motor and Sensory Disturbances56

Lesions Involving Both the Posterior and the Lateral Columns56

Transverse Lesions of the Spinal Cord57

Distinctions Between Partial and Total Transection of the Spinal Cord61

Unilateral Lesions of the Spinal Cord62

Differential Diagnosis Between Extramedullay(Intradural)and Intramedullary Spinal Tumors66

CHAPTER 4 ANATOMICAL AND FUNCTIONAL ASPECTS OF SPINAL SEGMENTS69

CHAPTER 5 SEGMENTAL LOCALIZATION OF SPINAL LESIONS73

The Localization of Motor Changes of Spinal Origin73

The Localization of Sensory Changes of Spinal Origin88

The Localization of Reflex Changes of Spinal Origin93

The Alignment of Spinal Cord Segments and Vertebral Spinous Processes95

CHAPTER 6 LOCALIZATION OF LESIONS OF THE CERVICAL AND UPPERMOST THORACIC SEGMENTS98

Compression of the Spinal Cord in the Region of the Foramen Magnum98

Cervical Disk Herniation99

Horner＇s Syndrome99

Respiratory Disturbances103

Pulse Disturbances103

Vasomotor and Sudomotor Disturbances103

Behavior of Reflexes104

CHAPTER 7 THE LOCALIZATION OF LESIONS OF LOWER SEGMENTS OF THE SPINAL CORD105

Innervation and Function of the Urinary Bladder105

Disturbances of Bladder Function106

Innervation and Function of the Sigmoid and Rectum108

Disturbances of Rectal Function108

Innervation and Function of the Male Genital Organs108

Disturbances of Sexual Function109

Other Clinical Features of Conus Medullaris Lesions110

CHAPTER 8 X-RAY LOCALIZATION OF SPINAL TUMORS＆by Bernard S．Epstein，M．D113

CHAPTER 9 THE STRUCTURE OF THE BRAIN STEM118

Section Through the Lower Medulla Oblongata at the Level of the Pyramidal Decussation118

Section Through the Medulla Oblongata at the Level of the Sensory Decussation125

Section Through the Medulla Oblongata at the Level of the Lower Third of the IVth Ventricle126

Section Through the Medulla Oblongata at the Level of the IXth Nerve128

Section Through the Pons at the Level of the VIth and VIIth Nuclei129

Section Through the Pons at the Level of the Vth Nerve130

Section Through the Upper Part of the Pons at the Level of the Decussation of the IVth Nerve131

Section of the Midbrain at the Level of the Inferior Colliculus132

Section Through the Midbrain at a Lower Level of the Superior Colliculus135

Section Through an Upper Level of the Midbrain135

CHAPTER 10 GENERAL RULES FOR THE LOCALIZATION OF LESIONS IN THE BRAIN STEM136

General Features of the Brain Stem136

Principles of Localization of Brain Stem Lesions141

CHAPTER 11 THE LOCALIZATION OF LESIONS INVOLVING CRANIAL NERVES Ⅸ THROUGH Ⅻ157

Manifestations of Functional Loss157

The Hypoglossal Nerve157

The Spinal Accessory Nerve157

The Vagus Nerve161

The Glossopharyngeal Nerve162

Irritative Phenomena165

Differentiation of Supranuclear，Nuclear，and Infra-nuclear Lesions166

Disturbances Due to Unilateral Supranuclear Lesions166

Disturbances Due to Bilateral Supranuclear Lesions：Supranuclear Bulbar Palsy168

Paralysis of Nuclear Origin170

Paralysis of Infranuclear Origin170

CHAPTER 12 THE LOCALIZATION OF LESIONS INVOLVING THE FACIAL NERVE173

Anatomy and Functions173

Clinical Features of Nuclear and Infranuclear Lesions175

Supranuclear Innervation of Facial Movements181

Clinical Manifestations of Interruption of Supranuclear Facial Fibers182

CHAPTER 13 THE LOCALIZATION OF LESIONS INVOLVING THE ACOUSTIC NERVE183

The Vestibular Nerve183

Anatomy and Functions183

Tonic Neck and Labyrinthine Reflexes186

Ocular Nystagmus188

Vertigo191

The Cochlear Nerve193

Anatomy and Functions193

Clinical Features of Cochlear Nerve Disorders195

CHAPTER 14 LOCALIZATION OF LESIONS INVOLVING THE TRIGEMINAL NERVE200

Anatomy200

Symptoms and Signs of Interruption of Trigeminal Nerve203

Symptoms of Irritation of the Trigeminal Nerve205

Symptoms and Signs of Lesions of Root Ganglion and Divisions205

Disorders of Autonomic Components of the Trigeminal Nerve207

Localization of Lesions of the Nucleus of the Spinal Tract of the Trigeminal Nerve208

Manifestations of Supra-nuclear Lesions209

CHAPTER 15 LOCALIZATION OF LESIONS INVOLVING THE EXTRAOCULAR NERVES210

Anatomy210

Functions of the Extraocular Muscles213

Infranuclear Palsies214

Clinical Features214

Causes and Manifestations of Infranuclear Palsy216

Nuclear Palsies219

Conjugate Ocular Deviation220

Supranuclear Palsies222

CHAPTER 16 DISORDERS OF CEREBELLAR ORIGIN225

Anatomical and Functional Considerations225

General Orientation225

Afferent Pathways226

Efferent Pathways229

Clinical Features of Cerebellar Lesions231

Cerebellar Ataxia231

Cerebellar Hypotonia234

Disorders Observed in Association With Ataxia and Hypotonia235

The Importance of Ataxia as a Sign of Cerebellar Disturbance236

Ocular Nystagmus238

Involvement of Extra-Cerebellar Structures in the Presence of Cerebellar Lesions238

Cerebellar Disturbances Induced by Supratentorial Tumors240

CHAPTER 17 THE ARTERIAL SUPPLY OF THE BRAIN STEM AND CEREBELLUM AND SYNDROMES OF ARTERIAL OCCLUSION241

The Vertebral Arteries and Their Branches241

The Paramedian Bulbar Syndromes241

The Lateral Bulbar Syndrome243

Syndromes of Occlusion of Branches of the Vertebral Artery244

Syndrome of Total Occlusion of Vertebral Artery244

The Basilar Artery and Its Branches245

The Anterior Inferior Cerebellar Artery245

The Internal Auditory Artery247

The Pontile Arteries and the Syndromes of Their Occlusion247

The Superior Cerebellar Artery250

Midbrain Branches of the Posterior Cerebral，Basilar and Anterior Choroidal Arteries251

CHAPTER 18 THE CEREBRAL CORTEX AND ITS MOTOR PATHWAYS254

General Organization and Functions254

Functional Subdivisions of the Cortex258

Corticofugal and Corticopetal Pathways262

Corticofugal Fiber Systems262

Corticopetal Fiber System263

Components of the Corona Radiata and Internal Capsule263

Craniocerebral Topography265

CHAPTER 19 THE LOCALIZATION OP MOTOR AND SENSORY DISTURBANCES OF CEREBRAL ORIGIN266

Disturbances of Motility and Sensibility of Cortical Origin266

Motor Deficit Due to Corticosubcortical Lesions266

Sensory Deficit Due to Cortical Lesions269

Manifestations of Excitation of the Motor Cortex273

Sensory Irritative Phenomena276

Disturbances of Motility and Sensibility of Subcortical Origin277

Manifestations of Lesions of the Centrum Semiovale277

Manifestations of Lesions of the Internal Capsule277

Characteristics of Acute Internal Capsular Lesions278

Characteristics of Chronic Internal Capsular Lesions278

Atypical Forms of Cerebral Hemiplegia282

Clinical Features of Temporal Lobe Lesions283

Hearing283

Smell283

Taste284

Other Sensory，and Motor Disturbances284

Disturbances in Behavior and the Occurrence of Seizures284

Effects of Brain Shifts in the Presence of Intracranial Masses286

Medial Shift of a Hemisphere287

Downward Shift of the Brain287

CHAPTER 20 THE LOCALIZATION OF FRONTAL LOBE DISORDERS289

Frontal Release and Allied Phenomena289

＇Frontal Ataxia，＇293

Mental Disturbanes294

CHAPTER 21 THE LOCALIZATION OF DISTURBANCES OF VISION AND PUPILLARY REFLEXES295

Anatomical Considerations295

The Localization of Lesions Interrupting the Optic Pathways299

Lesions Involving the Optic Nerve299

Lesions Involving the Optic Chiasm299

Lesions Involving the Optic Tract302

Lesions Involving the Visual Radiation304

Lesions Involving the Visual Cortex306

Positive and Negative Scotomas in Lesions of the Visual Pathway308

Opticokinetic Nystagmus309

Visual Agnosia and Alexia309

Metamorphopias311

Visual Inattention，or Extinction312

Localizing Value of Papilledema312

Localizing Value of Optic Atrophy315

CHAPTER 22 THE LOCALIZATION OF ANARTHRIA，APHASIA AND APRAXIA317

Anarthria and Aphasia317

Apraxia321

CHAPTER 23 THE LOCALIZATION OF EXTRAPYRAMIDAL MOTOR DISORDERS324

Anatomical and Functional Background324

Afferent Systems324

Efferent Systems326

Localization of Extrapyramidal Disorders328

Clinical Syndromes330

Disorders Characterized by Rigidity，with or without Static Tremor330

Variable Rigidity，Usually with Action Tremor335

Variable Rigidity with Alternating Swings of Posture，Either Athetoid or Choreo-athetoid336

Continuous Involuntary Movements with or without Rigidity340

CHAPTER 24 THE LOCALIZATION OF LESIONS OF THE THALAMUS342

Anatomical and Functional Considerations＆by Paul I．Yakovlev，M．D342

The Subdivisions of the Pallium342

Thalamic Nuclei344

Clinical Considerations352

General Disturbances352

The Thalamic Syndrome353

CHAPTER 25 THE CLINICAL FEATURES OP LESIONS OF THE HYPOTHALAMUS，PITUITARY GLAND AND UPPER MIDBRAIN355

Hypothalamic Disorders355

Hypopituitary States364

Acromegaly364

Chromophobe Adenoma of the Pituitary and Craniopharyngioma366

CHAPTER 26 ARTERIES OF THE CEREBRUM AND SYNDROMES OF THEIR OCCLUSION370

The Circle of Willis370

The Internal Carotid Artery371

Anatomy371

Syndromes of Occlusion371

The Posterior Communicating Artery373

The Anterior Choroidal Artery373

Anatomy373

Syndromes of Occlusion375

The Anterior Cerebral Artery375

Anatomy375

Syndromes of Occlusion380

The Middle Cerebral Artery380

Anatomy380

Syndromes of Occlusion382

The Posterior Cerebral Artery382

Anatomy382

Syndromes of Occlusion385

CHAPTER 27 LOCALIZATION OF ANEURYSMS OF CEREBRAL ARTERIES387

Manifestations of Rupture of an Aneurysm387

Cerebrospinal Fluid388

Manifestations of Aneurysm Prior to Hemorrhage389

CHAPTER 28 INTRACRANIAL TUMORS：LOCATION，TYPE，CEREBROSPINAL FLUID394

Location and Clinical Peculiarities of Various Intracranial Tumors394

Meningiomas394

Cerebral Angioma397

Pinealoma397

Gliomas of the Cerebrum and Brain Stem398

Cerebellar Tumors402

Cerebrospinal Fluid in Intracranial Tumors404

CHAPTER 29 X-RAY LOCALIZATION OF INTRACRANIAL LESIONS，ESPECIALLY TUMORS＆by Bernard S．Epstein，M．D405

Changes in Plain Films405

Pneumoencephalography411

Cerebral Angiography416

CHAPTER 30 THE USE OF ELECTROENCEPHALOGRAPHY IN NEUROLOGICAL DIAGNOSIS＆by Richard G．Berry，M．D419