By Martin A. Samuels, MD, DSc(hon), FAAN, MACP Chairman, Department of Neurology Brigham and Women’s Hospital Professor of Neurology Harvard Medical School 75 Francis Street Boston, MA
Neuroanatomy is a nightmare for most medical students. The complex array of nuclei, ganglia, tracts, lobes, Brodmann areas and cortical layers seem to the uninitiated as the height of useless trivia. My own memory of my neuroanatomy class in medical school is vivid. Our professor ordered each member of the class to buy a set of colored pencils; the kind you had in third grade. Each color was coded for particular structures (red for the caudate, green for the putamen, yellow for the claustrum and burnt sienna of for the globus pallidus). At our senior play, which poked fun at our professors, a beleaguered medical student was asked to name the components of the basal ganglia. Without knowing what the structures even were or did, he responded “red, green, yellow, and burnt sienna.” Almost forty years later, this remains a class joke. Except for the handful of us who went into neurology, neurosurgery and psychiatry, the basal ganglia to the rest of my class is just a fading joke from the distant past.
And yet, no one can practice even rudimentary neurology without some basic understanding of the neuroanatomy. Non-neurologists in particular, many of whom see large numbers of patients with neurological complaints, have no hope of sorting out common problems such as headache, dizziness, tiredness, fatigue, sleep disorders, numbness and tingling and pain, without a reasonable grasp of how the nervous system is organized. Despite all of the marvelous advances in neuroscience, genetics and neuroimaging, the actual practice of neurology, whether it is done by a neurologist or a non-neurologist involves localizing the problem. The nervous system is just too complicated to skip this step. Without an organized approach based on a reasonable understanding of functional neuroanatomy, clinical neurology becomes incomprehensible.
In his wonderful book, Neuroanatomy: Draw It to Know It, neurologist Adam Fisch applies my old neuroanatomy professor’s colored pencil idea in a manner that actually works, and it’s fun! Over the course of 39 chapters, most of the clinically important neuroanatomically important subjects are covered, ranging through the overall organization of the nervous system, the coverings of the brain, the peripheral nervous system, the spinal cord, the brainstem, the cerebellum and the cerebral cortex. It is clear that the book was written by an experienced neurologist, as the topics are organized in a fashion that illuminates the principle of anatomical-pathophysiological correlation, which is the tool with which neurologists approach clinical problems.
This book should be of great interest to all neurologists, neurosurgeons, neurology residents and students of neurology. Others who see patients with neurological complaints, such as internists, emergency physicians and obstetrician-gynecologists should also review their neuroanatomy if they wish to provide excellent care to their patients. As any experienced teacher knows, one only really knows a subject when one can teach it oneself. By drawing the anatomy, the reader of this book literally teaches the subject to himself. By making it clinically relevant, the information learned in this manner is likely to stick. Adam Fisch has done us all a great service by rekindling the enjoyment in learning the relevant, elegant anatomy of the nervous system.