Rapid Neurology and Neurosurgery

Kumar Abhinav, Richard Edwards, Alan Whone

• Publisher: Wiley-Blackwell
• Year: 2012
• ISBN:
  9781118308516
• Edition: 1
• Topic: Medicine
• Subtopic: Neurology

RAPID Neurology & Neurosurgery

The Rapids are a series of two-colour reference and revision pocket books that cover key facts in a simple and memorable way. Each book covers the common conditions or drugs that students and junior doctors encounter on the wards, in clinics, and in their exams. The core relevant facts are provided to ensure these books are perfect concise 'rapid refreshers'. To see all titles in the series, go to: www.wiley.com/go/rapids

Rapid Neurology and Neurosurgery is a must for all medical students and junior doctors-it is a quick and easy on-the-ward or clinical reference and the perfect revision tool for those approaching finals, undergraduate neurology and neurosurgery examinations and the Membership of Royal College of Surgeons (MRCS) examinations.

It provides a concise, structured approach to neurology and neurosurgery learning, covering key fact in a simple and memorable way:

PART I (The Basics) features the basic principles and facts essential for a good understanding of neurology and neurosurgery and includes sections on relevant neuroanatomy, neurological history and examination, and investigation including neurophysiology and neuroradiology. MRI and CT scans are included throughout the text.

PART II (Complaints: Face-to-Face with the patient) features OSCE-style and viva-voce examination preparation and has chapters on presenting complaints, with relevant and selected questions to ask for establishing the differential diagnoses (presented in a table) with basic investigations and management.

PART III (Conditions: Applying the basics) presents important clinical conditions with sections on definition, epidemiology, aetiology, associations/risk factors, pathology, history, examination, investigations, management, complications, prognosis and a list of differential diagnoses with general clinical information and distinguishing information to exclude the alternative diagnoses.

Each chapter includes key points to remember and highlights key facts.

Rapid Neurology and Neurosurgery contains only the essential, core, and relevant facts in a concise, pocket-sized, 'rapid' refresher-providing a thorough foundation of neurology and neurosurgery knowledge that will allow you to excel in the examinations.

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Part I

The Basics

Chapter 1

About this Book and How to Use it

The principal purpose of this book is to act as a quick revision tool for medical students approaching finals or other undergraduate neurology/neurosurgery exams. Although the book is intended as a quick revision tool, using it diligently and devoting time to understanding the basic concepts outlined herein will allow you to neurologically flourish rather than simply pass exams. The book is designed for both the newer type of written exams, including multiple choice questions (MCQ) as well as the extended matching questions (EMQ), and traditional exams requiring long and short answers. This book is also designed to prepare you for the Objective Structured Clinical Examinations (OSCE); in particular, Part II is geared towards this purpose.

The book is divided into three parts. Part I gives you the necessary basic principles and facts essential for building a foundation in clinical neurology/neurosurgery at an undergraduate level. Only clinically relevant neuroanatomy is presented along with an introduction to the topics of neurological history, examination and investigations. In particular, we have tried to simplify neuroradiological concepts and presented the rationale for using different imaging modalities.

Part II is very much geared towards the OSCE and the viva voce exams in finals. This section consists of chapters dealing with various presenting complaints. Lists of focussed and discriminating questions for determining the important differential diagnoses are included in these chapters along with tables listing the relevant disease entities in order of incidence. Please note, however, that you will also be expected to ask other relevant questions not listed in the chapters while taking a detailed history, including past medical history, drug history and social history. Additional important clinical information for each presenting complaint is included. The tables of potential differential diagnoses are supplemented by information on basic investigations and management. Again, in an exam setting you will have to be guided by the clinical information and suggest a list of focussed and relevant investigations! This part of the book can also act as a worthy quick reference on wards and in clinics.

Part III presents the important clinical neurological and neurosurgical conditions with focussed pertinent clinical information. Neurological topics are presented first followed by neurosurgical topics with the exception of the chapter on subarachnoid haemorrhage, which is included under ‘stroke’. Part III like other parts is interspersed with sentences beginning with ‘Remember . . .’ and designed to highlight key facts from the chapter. At the end of each chapter there is a list of common differential diagnoses (up to a maximum of four–five) for the particular condition described. General clinical details are provided, including, where applicable, information that can be used to distinguish between or exclude the alternative conditions. This should be of particular help for the EMQ section of the exam and will also prove useful in the OSCE when presenting a list of potential differential diagnoses.

Some of the chapters in the book may not strictly follow the format as laid out above and will generally be due to the nature of the topic and thereby the limitations of presenting it in a specific format.

We hope that the format; organisation and simple language employed will facilitate quick and effective revision and will help you perform well in all sorts of undergraduate examinations. Moreover, we trust this book will permit a better understanding of the basic concepts underpinning neurology and neurosurgery and thus provide a firm basis upon which to build your clinical neurological/neurosurgical expertise as you journey through your medical career.

Good Luck!

Chapter 2

Basic Neuroanatomy

The following section aims to present only the very relevant anatomical information.

Cortical Anatomy

Figure 2.1 demonstrates the following relevant key areas on the cortical surface:

Figure 2.1 Lateral surface of cerebral hemisphere demonstrating cortical surface anatomy.

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Remember: The association between dominant hemisphere and speech areas and therefore a further important point about ascertaining handedness of patients at the beginning of obtaining a neurological history.

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Figure 2.1 Lateral surface of cerebral hemisphere demonstrating cortical surface anatomy.

• Primary motor cortex: Situated anterior to central sulcus (frontal lobe) in the precentral gyrus; involved in contralateral motor function—Brodmann's (Br.) Area 4.
• Primary somatosensory cortex: Situated posterior to central sulcus (parietal lobe) in the postcentral gyrus; involved in contralateral sensory function—Br. Areas 1, 2 and 3.
• Motor speech area: In the dominant hemisphere only (left hemisphere for right-handed subjects and usually left hemisphere for left-handed people); anatomically situated in the inferior frontal gyrus (pars triangularis and opercularis); also known as ‘Broca's area’ and involved in speech output—Br. Area 44.
• Wernicke's area: In the dominant hemisphere; anatomically situated in the supramarginal gyrus—Br. Area 40 (part of inferior parietal l...

Table of contents

• Cover
• Title Page
• Copyright
• List of Abbreviations
• Preface
• Acknowledgements
• Part I: The Basics
• Part II: Complaints: Face-to-Face with the Patient
• Part III: Conditions: Applying the Basics
• Appendices
• Index