CHAPTER 1 TRACTS，CELL GROUPS AND BLOOD SUPPLY OF THE SPINAL CORD 17
Introduction 17
Tracts of the Spinal Cord 17
Descending Exogenous Tracts 18
Tracts Descending from the Cerebral Cortex 18
Tracts Descending from Subcortical Structures 19
Ascending Exogenous Tracts 21
Short Posterior Root Fibers and Ascending Pathways 21
Intermediate Posterior Root Fibers and Ascending Pathways 23
Long Posterior Root Fibers and Ascending Pathways 24
Intersegmental，or Association，Tracts 25
Anterior Root Fibers 26
Topography of the Long Spinal Tracts 26
Nerve Cell Groups of the Spinal Cord 27
Blood Supply of the Spinal Cord 29
Arterial Supply 29
Venous Return from the Spinal Cord 31
CHAPTER 2 SPINAL CORD FUNCTIONS 32
Sensory Function of the Spinal Cord 32
Superficial，or Exteroceptive，Sensibility 32
Deep，or Proprioceptive，Sensibility 32
Combined Sensibility 33
Impulses from the Periphery Which Do Not Enter Consciousness 33
Summary of the Spinal Pathways Conveying Afferent Impulses 34
Somatic Motor Function of the Spinal Cord 35
Voluntary Movement 35
Tonus and Reflexes 36
Trophic Function of the Spinal Cord 37
Visceral Motor Functions of the Spinal Cord 38
Vasomotor Function 38
Sudomotor Function 42
Pilomotor Function 43
CHAPTER 3 THE LOCALIZATION OF SPINAL LESIONS IN THE TRANSVERSE PLANE 44
The Localization of Lesions Causing Disturbances of Motility 44
The Characteristics of Motor Disturbances Due to Pyramidal Lesions 44
The Characteristics of Paralysis Due to Anterior Horn Lesions 48
The Manifestations of Lesions Involving Both the Pyramidal Tract and the Anterior Horn 50
The Localization of Disturbances of Sensibility 51
Localizing Significance of Combined Motor and Sensory Disturbances 56
Lesions Involving Both the Posterior and the Lateral Columns 56
Transverse Lesions of the Spinal Cord 57
Distinctions Between Partial and Total Transection of the Spinal Cord 61
Unilateral Lesions of the Spinal Cord 62
Differential Diagnosis Between Extramedullay(Intradural)and Intramedullary Spinal Tumors 66
CHAPTER 4 ANATOMICAL AND FUNCTIONAL ASPECTS OF SPINAL SEGMENTS 69
CHAPTER 5 SEGMENTAL LOCALIZATION OF SPINAL LESIONS 73
The Localization of Motor Changes of Spinal Origin 73
The Localization of Sensory Changes of Spinal Origin 88
The Localization of Reflex Changes of Spinal Origin 93
The Alignment of Spinal Cord Segments and Vertebral Spinous Processes 95
CHAPTER 6 LOCALIZATION OF LESIONS OF THE CERVICAL AND UPPERMOST THORACIC SEGMENTS 98
Compression of the Spinal Cord in the Region of the Foramen Magnum 98
Cervical Disk Herniation 99
Horner＇s Syndrome 99
Respiratory Disturbances 103
Pulse Disturbances 103
Vasomotor and Sudomotor Disturbances 103
Behavior of Reflexes 104
CHAPTER 7 THE LOCALIZATION OF LESIONS OF LOWER SEGMENTS OF THE SPINAL CORD 105
Innervation and Function of the Urinary Bladder 105
Disturbances of Bladder Function 106
Innervation and Function of the Sigmoid and Rectum 108
Disturbances of Rectal Function 108
Innervation and Function of the Male Genital Organs 108
Disturbances of Sexual Function 109
Other Clinical Features of Conus Medullaris Lesions 110
CHAPTER 8 X-RAY LOCALIZATION OF SPINAL TUMORS＆by Bernard S．Epstein，M．D 113
CHAPTER 9 THE STRUCTURE OF THE BRAIN STEM 118
Section Through the Lower Medulla Oblongata at the Level of the Pyramidal Decussation 118
Section Through the Medulla Oblongata at the Level of the Sensory Decussation 125
Section Through the Medulla Oblongata at the Level of the Lower Third of the IVth Ventricle 126
Section Through the Medulla Oblongata at the Level of the IXth Nerve 128
Section Through the Pons at the Level of the VIth and VIIth Nuclei 129
Section Through the Pons at the Level of the Vth Nerve 130
Section Through the Upper Part of the Pons at the Level of the Decussation of the IVth Nerve 131
Section of the Midbrain at the Level of the Inferior Colliculus 132
Section Through the Midbrain at a Lower Level of the Superior Colliculus 135
Section Through an Upper Level of the Midbrain 135
CHAPTER 10 GENERAL RULES FOR THE LOCALIZATION OF LESIONS IN THE BRAIN STEM 136
General Features of the Brain Stem 136
Principles of Localization of Brain Stem Lesions 141
CHAPTER 11 THE LOCALIZATION OF LESIONS INVOLVING CRANIAL NERVES Ⅸ THROUGH Ⅻ 157
Manifestations of Functional Loss 157
The Hypoglossal Nerve 157
The Spinal Accessory Nerve 157
The Vagus Nerve 161
The Glossopharyngeal Nerve 162
Irritative Phenomena 165
Differentiation of Supranuclear，Nuclear，and Infra-nuclear Lesions 166
Disturbances Due to Unilateral Supranuclear Lesions 166
Disturbances Due to Bilateral Supranuclear Lesions：Supranuclear Bulbar Palsy 168
Paralysis of Nuclear Origin 170
Paralysis of Infranuclear Origin 170
CHAPTER 12 THE LOCALIZATION OF LESIONS INVOLVING THE FACIAL NERVE 173
Anatomy and Functions 173
Clinical Features of Nuclear and Infranuclear Lesions 175
Supranuclear Innervation of Facial Movements 181
Clinical Manifestations of Interruption of Supranuclear Facial Fibers 182
CHAPTER 13 THE LOCALIZATION OF LESIONS INVOLVING THE ACOUSTIC NERVE 183
The Vestibular Nerve 183
Anatomy and Functions 183
Tonic Neck and Labyrinthine Reflexes 186
Ocular Nystagmus 188
Vertigo 191
The Cochlear Nerve 193
Anatomy and Functions 193
Clinical Features of Cochlear Nerve Disorders 195
CHAPTER 14 LOCALIZATION OF LESIONS INVOLVING THE TRIGEMINAL NERVE 200
Anatomy 200
Symptoms and Signs of Interruption of Trigeminal Nerve 203
Symptoms of Irritation of the Trigeminal Nerve 205
Symptoms and Signs of Lesions of Root Ganglion and Divisions 205
Disorders of Autonomic Components of the Trigeminal Nerve 207
Localization of Lesions of the Nucleus of the Spinal Tract of the Trigeminal Nerve 208
Manifestations of Supra-nuclear Lesions 209
CHAPTER 15 LOCALIZATION OF LESIONS INVOLVING THE EXTRAOCULAR NERVES 210
Anatomy 210
Functions of the Extraocular Muscles 213
Infranuclear Palsies 214
Clinical Features 214
Causes and Manifestations of Infranuclear Palsy 216
Nuclear Palsies 219
Conjugate Ocular Deviation 220
Supranuclear Palsies 222
CHAPTER 16 DISORDERS OF CEREBELLAR ORIGIN 225
Anatomical and Functional Considerations 225
General Orientation 225
Afferent Pathways 226
Efferent Pathways 229
Clinical Features of Cerebellar Lesions 231
Cerebellar Ataxia 231
Cerebellar Hypotonia 234
Disorders Observed in Association With Ataxia and Hypotonia 235
The Importance of Ataxia as a Sign of Cerebellar Disturbance 236
Ocular Nystagmus 238
Involvement of Extra-Cerebellar Structures in the Presence of Cerebellar Lesions 238
Cerebellar Disturbances Induced by Supratentorial Tumors 240
CHAPTER 17 THE ARTERIAL SUPPLY OF THE BRAIN STEM AND CEREBELLUM AND SYNDROMES OF ARTERIAL OCCLUSION 241
The Vertebral Arteries and Their Branches 241
The Paramedian Bulbar Syndromes 241
The Lateral Bulbar Syndrome 243
Syndromes of Occlusion of Branches of the Vertebral Artery 244
Syndrome of Total Occlusion of Vertebral Artery 244
The Basilar Artery and Its Branches 245
The Anterior Inferior Cerebellar Artery 245
The Internal Auditory Artery 247
The Pontile Arteries and the Syndromes of Their Occlusion 247
The Superior Cerebellar Artery 250
Midbrain Branches of the Posterior Cerebral，Basilar and Anterior Choroidal Arteries 251
CHAPTER 18 THE CEREBRAL CORTEX AND ITS MOTOR PATHWAYS 254
General Organization and Functions 254
Functional Subdivisions of the Cortex 258
Corticofugal and Corticopetal Pathways 262
Corticofugal Fiber Systems 262
Corticopetal Fiber System 263
Components of the Corona Radiata and Internal Capsule 263
Craniocerebral Topography 265
CHAPTER 19 THE LOCALIZATION OP MOTOR AND SENSORY DISTURBANCES OF CEREBRAL ORIGIN 266
Disturbances of Motility and Sensibility of Cortical Origin 266
Motor Deficit Due to Corticosubcortical Lesions 266
Sensory Deficit Due to Cortical Lesions 269
Manifestations of Excitation of the Motor Cortex 273
Sensory Irritative Phenomena 276
Disturbances of Motility and Sensibility of Subcortical Origin 277
Manifestations of Lesions of the Centrum Semiovale 277
Manifestations of Lesions of the Internal Capsule 277
Characteristics of Acute Internal Capsular Lesions 278
Characteristics of Chronic Internal Capsular Lesions 278
Atypical Forms of Cerebral Hemiplegia 282
Clinical Features of Temporal Lobe Lesions 283
Hearing 283
Smell 283
Taste 284
Other Sensory，and Motor Disturbances 284
Disturbances in Behavior and the Occurrence of Seizures 284
Effects of Brain Shifts in the Presence of Intracranial Masses 286
Medial Shift of a Hemisphere 287
Downward Shift of the Brain 287
CHAPTER 20 THE LOCALIZATION OF FRONTAL LOBE DISORDERS 289
Frontal Release and Allied Phenomena 289
＇Frontal Ataxia，＇ 293
Mental Disturbanes 294
CHAPTER 21 THE LOCALIZATION OF DISTURBANCES OF VISION AND PUPILLARY REFLEXES 295
Anatomical Considerations 295
The Localization of Lesions Interrupting the Optic Pathways 299
Lesions Involving the Optic Nerve 299
Lesions Involving the Optic Chiasm 299
Lesions Involving the Optic Tract 302
Lesions Involving the Visual Radiation 304
Lesions Involving the Visual Cortex 306
Positive and Negative Scotomas in Lesions of the Visual Pathway 308
Opticokinetic Nystagmus 309
Visual Agnosia and Alexia 309
Metamorphopias 311
Visual Inattention，or Extinction 312
Localizing Value of Papilledema 312
Localizing Value of Optic Atrophy 315
CHAPTER 22 THE LOCALIZATION OF ANARTHRIA，APHASIA AND APRAXIA 317
Anarthria and Aphasia 317
Apraxia 321
CHAPTER 23 THE LOCALIZATION OF EXTRAPYRAMIDAL MOTOR DISORDERS 324
Anatomical and Functional Background 324
Afferent Systems 324
Efferent Systems 326
Localization of Extrapyramidal Disorders 328
Clinical Syndromes 330
Disorders Characterized by Rigidity，with or without Static Tremor 330
Variable Rigidity，Usually with Action Tremor 335
Variable Rigidity with Alternating Swings of Posture，Either Athetoid or Choreo-athetoid 336
Continuous Involuntary Movements with or without Rigidity 340
CHAPTER 24 THE LOCALIZATION OF LESIONS OF THE THALAMUS 342
Anatomical and Functional Considerations＆by Paul I．Yakovlev，M．D 342
The Subdivisions of the Pallium 342
Thalamic Nuclei 344
Clinical Considerations 352
General Disturbances 352
The Thalamic Syndrome 353
CHAPTER 25 THE CLINICAL FEATURES OP LESIONS OF THE HYPOTHALAMUS，PITUITARY GLAND AND UPPER MIDBRAIN 355
Hypothalamic Disorders 355
Hypopituitary States 364
Acromegaly 364
Chromophobe Adenoma of the Pituitary and Craniopharyngioma 366
CHAPTER 26 ARTERIES OF THE CEREBRUM AND SYNDROMES OF THEIR OCCLUSION 370
The Circle of Willis 370
The Internal Carotid Artery 371
Anatomy 371
Syndromes of Occlusion 371
The Posterior Communicating Artery 373
The Anterior Choroidal Artery 373
Anatomy 373
Syndromes of Occlusion 375
The Anterior Cerebral Artery 375
Anatomy 375
Syndromes of Occlusion 380
The Middle Cerebral Artery 380
Anatomy 380
Syndromes of Occlusion 382
The Posterior Cerebral Artery 382
Anatomy 382
Syndromes of Occlusion 385
CHAPTER 27 LOCALIZATION OF ANEURYSMS OF CEREBRAL ARTERIES 387
Manifestations of Rupture of an Aneurysm 387
Cerebrospinal Fluid 388
Manifestations of Aneurysm Prior to Hemorrhage 389
CHAPTER 28 INTRACRANIAL TUMORS：LOCATION，TYPE，CEREBROSPINAL FLUID 394
Location and Clinical Peculiarities of Various Intracranial Tumors 394
Meningiomas 394
Cerebral Angioma 397
Pinealoma 397
Gliomas of the Cerebrum and Brain Stem 398
Cerebellar Tumors 402
Cerebrospinal Fluid in Intracranial Tumors 404
CHAPTER 29 X-RAY LOCALIZATION OF INTRACRANIAL LESIONS，ESPECIALLY TUMORS＆by Bernard S．Epstein，M．D 405
Changes in Plain Films 405
Pneumoencephalography 411
Cerebral Angiography 416
CHAPTER 30 THE USE OF ELECTROENCEPHALOGRAPHY IN NEUROLOGICAL DIAGNOSIS＆by Richard G．Berry，M．D 419