The United States Congress designated the 1990's as the "Decade of the Brain" in recognition of the importance of neuroscience to the health and well-being of Americans. It has been suggested that as many as 20% of all patients seeking medical treatment have neurologic problems, either as the presenting complaint or as an associated condition complicating the primary illness. To this end, it is important that physicians understand basic neuroscience principles and nervous system diseases. Of course, this text is not encyclopedic but instead is an outline of the knowledge required of all medical students. Interested students can consult numerous texts that provide comprehensive coverage of the field, including Greenfield's Neuropathology and the exhaustive 60 + volume Handbook of Clinical Neurology. The information selected for inclusion in this volume of the Oklahoma Notes series remains true to the goal of the whole series-incorporating only that material vital in both the general clinical practice of medicine and to answer questions on the all-important United States Medical Licensing Examination. Roger A. Brumback Richard W. Leech Acknowledgments This text would not have been possible without a great deal of help and support from a number of individuals. We want to thank all those who assisted in our education in neuroscience and neuropathology including: William M. Landau and Philip R. Dodge of the Washington University School of Medicine, Lowell W. Lapham of the University of Rochester Medical Center, and Ellsworth C.

1. Nervous System Structure and Function.- Componentsr.- Central nervous system subdivisions.- Spinal cord.- Brain stem.- Cerebellum.- Diencephalon.- Basal ganglia.- Corticoid and allocortex.- Cerebral cortex.- Blood supply.- Neuron.- Axon.- Dendrite.- Neuronal physiology.- Acetylcholine.- Dopamine.- Norepinephrine.- Serotonin.- ?-Aminobutyric acid (GABA).- Glycine.- Glutamate.- Opioids.- Neuroglia.- Astrocyte.- Oligodendrocyte.- Ependymal cell.- Microglial cell.- Endothelial cells.- Pia-arachnoid.- 2. Principles of Cerebral Localization Syndromes.- Hemisyndromes.- Behavioral syndromes.- Frontal lobe syndromes.- Parietal lobe syndromes.- Temporal lobe syndromes.- Occipital lobe syndromes.- Basal ganglia syndromes.- Thalamic syndromes.- Hypothalamic syndromes.- Brain stem syndromes.- Cerebellar syndromes.- Spinal cord syndromes.- Peripheral nervous system syndromes.- Visual disturbances.- Vertigo, dizziness, unsteadiness.- Unilateral facial paralysis.- Gait disturbances.- Epilepsy and seizure disorder.- 3. Brain Edema and Mass Effect Edema.- Intracranial fluid dynamics.- Brain herniation.- 4. Pathology of Cerebrovascular Disease Stroke.- Hypoxia, ischemia, infarction.- Hypoxic/ischemic encephalopathy.- Transient ischemic attacks (TIA' s).- Fibromuscular dysplasia.- Moyamoya disease.- Cerebral amyloid angiopathy (congophilic angiopathy).- Arteritis (vasculitis).- Hypertensive cerebrovascular disease.- Intracranial vascular aneurysms.- Arteriovenous malformations.- Subependymal and intraventricular hemorrhage.- 5. Pathology of Central Nervous System Infections.- Sites of CNS infections.- Blood-brain barrier.- Meningitis.- Focal suppurative infections.- Fungal and parasitic CNS infections.- Neurosyphilis.- Lyme disease.- Acquired immunodeficiency syndrome (AIDS).-Arbovirus encephalitis.- Herpesvirus encephalitis.- Poliomyelitis.- Rabies.- Subacute sclerosing panencephalitis (SSPE).- Transmissible spongiform encephalopathies.- 6. Neurodegenerative Diseases and Dementia Definitions.- Alzheimer' s disease.- Pick' s disease (lobar atrophy).- Parkinsonism (Parkinson' s syndrome).- Huntington' s disease (Huntington' s chorea).- Spinocerebellar degeneration.- 7. Nervous System Tumors Pathophysiology of symptoms.- Diagnosis of brain tumor.- Glioma.- Primitive neuroectodermal tumor (PNET).- Peripheral neuroblastoma.- Pheochromocytoma.- Craniopharyngioma.- Colloid cyst of third ventricle.- Meningioma.- Schwannoma (neurilemmoma).- Neurofibroma.- Hemangioblastoma of cerebellum (Lindau' s tumur).- Chordoma.- Primary central nervous system lymphoma.- Metastatic tumors.- 8. Pathology of Craniocerebral Trauma Craniocerebral trauma.- Missile injuries.- Closed head injury.- Delayed complications of head injury.- 9. Peripheral Nerve and Muscle Pathology Anatomy and physiology.- Electrophysiologic studies.- Pathology.- 10. Pathology of Toxic and Nutritional Diseases Central pontine myelinolysis.- Marchiafava-Bignami disease.- Methanol (methyl alcohol; wood alcohol) poisoning.- Ethylene glycol poisoning.- Lead poisoning.- Arsenic poisoning.- Mercury poisoning (organic or inorganic mercury).- Thallium poisoning.- Carbon monoxide poisoning.- Wernicke-Korsakoff syndrome.- Alcoholic cerebellar degeneration.- Vitamin E (?-tocopherol) deficiency.- Vitamin B deficiency.- Hypoglycemic encephalopathy.- Hepatic encephalopathy.- Uremic neuropathy.- Kernicterus.- Radiation effects.- 11. Pathology of Neurometabolic Disorders Gaucher' s disease.- Niemann-Pick disease.- GM2-gangliosidosis.- Fabry' s disease.- Ceroid lipofuscinoses.- Metachromaticleukodystrophy.- Krabbe' s disease (globoid cell leukodystrophy).- Peroxisomal disorders.- Mucopolysaccharidoses.- Aminoacid disorders.- Transferase-deficient galactosemia.- Glycogen storage disorders.- Wilson' s disease (hepatolenticular degeneration).- Alexander' s disease.- Canavan' s disease.- Leigh' s disease.- Lesch-Nyhan disease.- Porphyria.- 12. Pathology of Demyelinating Disorders Multiple sclerosis (MS).- Acute disseminated encephalomyelitis.- Acute necrotizing hemorrhagic encephalomyelitis.- Guillain-Barré syndrome.- 13. Nervous System Malformations Definitions.- Neural tube defects (dysraphic disorders).- Trisomy 21 syndrome (Down' s syndrome).- Hydrocephalus (hydrocephaly).- Anomalies of neuronal migration.- Hydranencephaly.- Porencephaly.- Multicystic encephalopathy.- Holoprosencephaly.- Encephalocele.- Agenesis of the corpus callosum.- Arrhinencephaly.- 14. Spinal Cord Pathology Vascular disorders.- Inflammatory conditions.- Spinal trauma.- Degeneration of intervertebral disc.- Rheumatoid arthritis.- Ossification of posterior longitudinal ligament.- Syringomyelia.- Neoplasms.- Spinal cord anomalies.- 15. Pineal Gland Pathology Anatomy and physiology.- Innervation of pineal gland.- Circumventricular secretory organs.- Pineal neoplasm.- Germ cell tumors.- 16. Pituitary Gland Pathology Pituitary gland location.- Embryonic derivation.- Vascular supply.- Cellular architecture of adenohypophysis.- Neurohypophyseal hormones.- Hypothalamic hypophysiotrophic hormones.- Adenohypophyseal hormones.- Adrenocorticotropic hormone (ACTH).- Thyrotropin.- Gonadotropins.- Human growth hormone.- Prolactin.- Pituitary adenoma.- 17. Eye Pathology Orbit.- Eyelids.- Cornea, sclera, and conjunctiva.- Anterior and posterior chambers.- Uveal tract.- Lens.- Vitreous.-Retina.- Vascular disease.- Pigmentary retinopathy.- 18. Ear Pathology External ear.- Middle ear.- Inner ear.- Cochlea.- Physiologic studies.- Otitis media.- Otosclerosis.- Ménière' s disease.- Self-assessment examination #1.- Self-assessment examination #2.- Answers to self-assessment examinations.