Table Of ContentGRAY’S
Clinical
Neuroanatomy
The Anatomic Basis for
Clinical Neuroscience
GRAY’S
Clinical
Neuroanatomy
The Anatomic Basis for
Clinical Neuroscience
Editor
Elliott L. Mancall, MD
Emeritus Professor of Neurology
Department of Neurology
Thomas Jefferson University
Jefferson Medical College
Philadelphia, Pennsylvania
Associate Editor
David G. Brock, MD, CIP
Medical Director
Neuronetics, Inc.
Malvern, Pennsylvania
Excerpts from Gray’s Anatomy
Susan Standring, Editor-in-Chief
Alan Crossman, Section Editor
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GRAY’S CLINICAL NEUROANATOMY: THE ANATOMIC BASIS FOR CLINICAL
NEUROSCIENCE ISBN: 978-1-4160-4705-6
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Dedication
To our wives, J.C.M. and C.A.S.—thank you for your support.
Elliott L. Mancall
David G. Brock
v
Contributors
Michael W. Devereaux, MD
Professor of Neurology
Department of Neurology
Case Western Reserve School of Medicine;
Staff Neurologist
Case Medical Center
Cleveland, Ohio
Karl Doghramji, MD
Professor of Psychiatry and Human Behavior, Neurology, and Medicine
Program Director, Fellowship in Sleep Medicine
Thomas Jefferson University;
Medical Director, Jefferson Sleep Disorders Center
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
Keith Dombrowski, MD
Fellow, Neurocritical Care
Department of Medicine, Division of Neurology
Duke University Medical Center
Durham, North Carolina
Laurie Gutmann, MD
Professor
Neurology and Exercise Physiology
West Virginia University School of Medicine;
Professor/CNP Fellowship Program Director
Neurology
Ruby Memorial Hospital
Morgantown, West Virginia
John Khoury, MD
Fellow in Sleep Medicine
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
Daniel Kremens, MD, JD
Assistant Professor of Neurology
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
vii
Preface
Gray’s Anatomy has been a cornerstone of medical education since its original appear-
ance in 1858. It has provided a remarkably authoritative description of both gross and
microscopic anatomy of the human body for many generations of medical students
and practicing medical scientists on a worldwide basis. It has been, and remains, cher-
ished not only as a primary source of anatomical knowledge but also as a reliable
resource to which the student or practitioner might return for many years, indeed,
throughout the entire length of a medical career. Although the classical text is regularly
updated, recent major developments in both basic and clinical medicine have prompted
a major reconsideration of the utility of a single large volume devoted to all of human
anatomy. Concerns are especially related to the increasing specialization, if not frank
fragmentation, of the medical arts with which the contemporary physician must deal
on a day-to-day basis. As a consequence of such a reappraisal, a decision has been
made to extract focused portions of the major text devoted to specific conceptual
domains. Gray’s Anatomy itself will remain as authoritative as ever but will be expanded
by the inclusion of clinical case material to illustrate in depth, whenever possible, the
application of anatomical principles to the bedside. The field of neuroanatomy lends
itself particularly well to such a departure from the more traditional approach to
human anatomy, with the original Gray’s material being utilized as the foundation for
such an enhanced pedagogical approach. In Gray’s Clinical Neuroanatomy, virtually all
the original neuroanatomical text in the thirty-ninth edition is preserved, although it is
transposed and rearranged to meet innovative structural guidelines and is comple-
mented by a host of clinical case vignettes, which in turn are augmented by visual
materials designed to strengthen the link between the clinic and the dissecting room.
It must be emphasized that there has been no attempt to develop yet another com-
prehensive textbook of neurology as such; the neurological disorders cited here are
entirely exemplary and directly relevant to the underlying anatomical principles of the
traditional Gray’s.
Organizationally, Gray’s Clinical Neuroanatomy begins with a selection of general,
non-systematized topics that lack a specific regional approach—for example, the
general vasculature of the brain and spinal cord, the ventricular system and the menin-
ges, as well as the general microstructure of the nervous system. A detailed review of
neuroembryology and development is also provided; the extraordinary length here
reflects the perceived need for in-depth coverage of these topics, which is not available
elsewhere. Following these introductory topics, the remaining sections are devoted to
the systematized gross and microscopic anatomy of the central and peripheral nervous
systems, considered on a regional and clinically pertinent basis, with direct relevance
to the bedside and the clinic and thus with direct applicability to the clinician treating
a patient with a neurological disease.
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