Neuroanatomy Through Clinical Cases
Starting with Andreas Vesalius' De Humani Corporis Fabrica (1543), anatomy texts have challenged in a fundamental way our understanding of the human body and determined how students are introduced to its wonders. Neuroanatomy texts can be especially enthralling to neophytes, but by the same token can turn them away from neuroscience if coming across as dry, unengaging, or irrelevant. As the Visible Human project has successfully demonstrated, progress in imaging techniques and the endless possibilities offered by cyberspace have led to novel and exciting ways of teaching and revisiting anatomy. Neuroanatomy Through Clinical Cases fits squarely within such a tradition, making it patently clear that an entirely new textbook on something as old and unchanging as the human body and brain can be achieved. And achieve it, this book spectacularly has.
The unique and innovative qualities of the book lie not only in the clarity of its text and the beauty of its illustrations, but also in its ability to seamlessly weave the descriptive with the functional, or the physiological with the clinically relevant. This feat has been achieved through a counterpoint between “Anatomical and Clinical Review” and “Clinical Cases” sections. Four introductory chapters provide a foundation on the clinical interview, neurological examination, and imaging studies, so that an integrated approach is feasible from the very start—even (especially) for first- and second-year medical students, for whom this book is likely to become a standard text.
Indeed, the book has the early career medical (or allied professions) student clearly in mind. Review exercises, key clinical concepts, discussion of clinical cases, focused questions, the liberal use of boldface type, a wealth of tables and imaging examples, and user-friendly mnemonics (the Spanish boca for [the aphasia of] Broca being one of our favorites) all make for an effective teaching armamentarium. Effective and fun: for example, the above mnemonics are indicated in the text with an icon depicting the hippocampus, and cerebrospinal fluid anatomy is reviewed in a “Scuba expedition through the brain,” an approach that encourages the student to literally visualize the structures from the inside out. To top it all off, an accompanying website with video clips of the neurological exam and a CD-ROM of all the illustrations (the latter available at extra charge) complement the book and are likely to make it as popular with instructors as with students.
The remaining fifteen chapters are divided along the traditional central nervous system boundaries, and include two chapters on the peripheral nervous system, so often a second-class citizen in other texts. All chapters have an introductory section detailing the neuroanatomical principles that govern the organization of the system under discussion. Case presentations are recorded as they would typically be found in a detailed medical chart and pose anatomically relevant questions that highlight the chapters' main concepts. The clinical richness and texture of the book will thus make it useful not only to medical students, but to residents in neurology, neurosurgery, medicine, and psychiatry as well.
Neuroanatomy incorporates a brief but relevant discussion of circuitry pertinent to psychiatric disorders, and even throws in as epilogue “A Simple Working Model of the Mind,” which takes a solid and unpretentious crack at some of the field's most enduring and intriguing questions: what, and where, are mind, consciousness, and emotion? While no easy answers are provided, the book does suggest where the author's own mind and emotions have been: it took well over a decade of his time and dogged commitment to compile the materials and write the close to 1,000 pages of text. The personal touch comes across not only in his writing, but in Blumenfeld's actual presence—in photographs where he exemplifies the finer points of the neurological exam.
The author's effort and commitment are evident in the final product: Neuroanatomy Through Clinical Cases seems a slam-dunk into the classics shelf. But that probably is not to be its major accomplishment or accolade: those are to be reserved for the effect that the book is likely to have on a whole new generation of students—turning many of them on to the excitement of the neurosciences. We sometimes come across a book we wish we had had when we ourselves were medical students and residents. After stopping to think about the possible effect such a book would have had on our own development, we resume our teaching endeavors revitalized, and recall in the glimmer of our students' eyes our own first understandings. This is such a book.
Dr. Merino is Assistant Professor of Neurology, University of Florida, Jacksonville, FL. Dr. Martin is Associate Professor of Child Psychiatry and Psychiatry, Child Study Center, Yale University School of Medicine, New Haven, CT.
