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Neuroanatomy: An Illustrated Colour Text - A.R. Crossman

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Genre: Health / Medical / Author: A.R. Crossman, David Neary / Paperback / 170 Pages / Book is published 1995-11 by Churchill Livingstone

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      23.08.2011 00:43
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      Great book overall and should be a must in any medical students library.

      ***************Introduction***************


      Ask any medical student what the worst subject in their entire curriculum is and I guarantee that 99% will say either neurology or neuroanatomy. The study of the brain and its integration with the rest of the body is possibly one of the most complex and least understood parts of medicine, a discipline which baffles students and consultants alike. Thankfully this struggle has not been overlooked by medical authors and there exists a wide multitude of books to help the troubled student through his or her predicament with the medulla oblongata or the falx cerebri. As is the case with any subject, different schools recommend different books and neurology is no different. My own alma mater and indeed my own personal recommendation is Neuroanatomy: An Illustrated Colour Text and Atlas by Alan Crossman and David Neary.

      Released first in 1995 and now in its fourth iteration as of 2011, Neuroanatomy ICT is a staple resource for a wide variety of medical students. First off it must be noted that the book does not provide enough material to achieve a first class honours grade in neurology, though not at any point does the book claim to be a complete resource. The purpose of this book is to provide the core principles of neurology and to give the student a solid grounding in how the central and peripheral nervous systems work, not to give the minutiae of Guillan Barre syndrome. One could argue that this detracts from the books usefulness but I would counter with that it provides enough of a ground for the student to learn "on the job" on the neurology ward, arguably a more efficient educational method. One could argue education all day however and this is a book review!


      ***************Organisation***************


      The book itself is split into seventeen short chapters on a particular sub system of the nervous system and finishes with a particularly useful chapter on problem solving. The chapters start at the very beginning and work up through the different sections touching on how they integrate and how damage in a particular area can affect another. On the surface this sounds great but the chapters fail to realise the true potential of this and leave the reader feeling unsatisfied and in places, confused.


      ***************Opening thoughts***************


      First off is an opening chapter which discuss the importance of the nervous system in the context of the body and how without it we would not be able to function. It's pretty basic stuff though I guess all books need to have an introduction and overview. I rarely read these chapters but it was interesting to see the thought process of two expert neurologists and how they feel the student should learn their speciality. It doesn't really add much to the book but at the same time the book would be off without its inclusion.


      ***************Laying a strong foundation***************


      The next three chapters; "Cells of the Nervous System", "Peripheral Nervous System" and "Autonomic Nervous System" are hands down the most important chapters of the entire book. Over the course of eighteen pages (I told you the chapters were brief) Crossman and Neary go through the cellular basics of the nervous system to quickly and thoroughly orientate the reader. If, like many students you wish to get straight to the good stuff and skip over these pages, you are doing yourself a massive injustice. Read and reread these eighteen pages and you will suddenly find that understanding the limbic system becomes an intuitive system as opposed to an impressionist painting. Eighteen pages has been expanded to hundreds elsewhere with good reason, these basic chapters are your bread and butter and Profs. Crossman and Neary have proven themselves to be master bakers, if you pardon the pun.


      ***************It might be gross but don't look away***************


      Following these chapters is a whistlestop tour of the gross anatomy of the meninges, ventricles and blood supply. This material is impossible to jazz up and so these pages read very dry. The authors are not at fault here, you can't make a soufflé from a pot of jam as my grandmother says. Worth a read but it's covered just as well elsewhere.


      ***************Good, Bad and the plain useless***************


      Starting at the cauda equina and working upwards the next three chapters discuss the spinal cord, brainstem and cranial nerve nuclei. The chapter covering the spinal cord is very useful and is taught from a clinical angle, taking great time to discuss how lesions of each of the various tracts will affect a patient. I would say that this and the three fundamental chapters mentioned earlier are the best portions of this book and that the cost of the book is worth it for these pages alone. In contrast to this the chapters on the brainstem and cranial nerves are very bland and uninteresting. The material is presented mainly in the form of cross section and makes very little attempt to relate the reader to the clinical picture. Admittedly this cross-sectional knowledge is important when taking spotters but its use drops off the second you step foot on the wards. I found these two chapters to be a real let down and probably do more to complicate the subjects involved than clear them up.


      ***************Cerebellum***************


      Keeping things steady the next chapter regards the cerebellum. Thankfully the authors get back to what they're good at here and give a nice balance between anatomical knowledge and clinical features. Cerebellar injuries are, besides classic strokes, one of the most common brain injuries that are shown to medical students. Crossman and Neary cover them very well and this chapter will leave the medical student very well prepared to answer their consultants questions if this chapter is thoroughly studied.


      ***************Thalamus***************


      Following on from the cerebellum and bringing us back to the lows of the brainstem chapter is eight pages on the thalamus. While I will admit that it is exceptionally difficult to make what is essentially a relay station very interesting, they could at least have tried. If you want to read eight pages of how point A links to point B and how C links to D then go ahead, if not, skip ahead. While I'm not a neurologist and it has been a number of years since I was questioned by one I managed to get by just fine without knowing this eight page bore. Read the chapter summary and you're ahead of the curve.


      ***************Back to the top***************


      Cerebral Hemispheres and the Cerebral Cortex. Careers have been made on far less. This chapter attempts to cover a vast mountain of material and I hate to say it but, they do a pretty good job. Playing to their strengths the authors stick to the clinical correlates, allowing them to focus on what is seen on the wards, not the reference books. Admittedly they miss a large portion of information that a qualified neurologist will need but no neurologist in their right mind would rely solely on an undergraduate text for reference. This chapter mostly talks about stroke and how a patient will present depending on their bleed location. This information is presented in a very clear, precise and logical fashion, allowing the student to deduce the cause of nearly any stroke from its presenting symptoms. It's not a catchall for what is a deeply complicated subject but it makes a great attempt at the topic.


      ***************And straight back down again***************


      In what appears to be a pattern this great chapter is followed up by another clanger, the Corpus Striatum. To be fair to the authors, the corpus striatum is one of the least understood and more abstract portions of the human brain so I can forgive them this chapter. Or at least I could if it weren't ten pages long and filled with unearthly gibberish. I won't dwell on this chapter as it only continues to make me sad; this is another chapter you can happily skip on your merry way towards your finals.


      ***************Don't look away***************


      Firmly establishing their pattern of alternating brilliance with utter trollop is an eye-catching piece on the visual system. Written almost purely from a clinical point of view this chapter starts at the surface of the eye and works backwards to the visual cortex, stopping off at each danger point along the way. Through the use of diagrams and clinical vignettes you are quickly given a thorough knowledge of how information is fed from your eyes to your brain and how a break at any point will affect you. Know this chapter and you are well ahead of the curve; the graphic describing visual field defects alone should pass your ophthalmology tutorials.


      ***************Triple Whammy to finish***************


      Breaking tradition Crossman and Neary redeem themselves with their last theoretical chapter, covering the Hypothalamus, Limbic System and Olfactory system with considerable aplomb. The section on the limbic system is weak but only relative to the thorough discussion of the others. The hypothalamus is more of an endocrine organ but is covered well regardless. The limbic system is a mess, reminiscent of the chapter on the striatum, confusing the reader more. Finishing up their tour of the brain the authors finish on a sweet smelling note with a quick cover of the olfactory system. All the main points are covered here, giving a solid if basic grounding. You'd want to consult another text before sitting your exam but it'll get you started and should leave you eager to sniff out further information.


      ***************Work your way through the book***************


      Rounding out the book is an interesting chapter entitled "Problem Solving". Here the authors present a wide variety of diagrams indicating various neurological deficits, prompting the reader to test their newly acquired clinical knowledge. It's a nice addition and further strengthens the books clinical bias, raising it above the wide array of other neuroanatomy books available today. My only gripe is that it is fairly short, weighing in at a paltry eight pages. I guess that as a textbook and not a workbook I shouldn't be surprised but it would add greatly to the book if this chapter could be expanded to even twenty pages.


      ***************Final Thoughts***************


      Overall I'm impressed with this book; it takes a fresh look at what is a traditionally difficult subject. While the authors don't present any radical new ideas or attempt to reinvent the wheel they do manage to humanise what can be very tedious and theoretical topic. The clinical bias and problem solving components to each chapter add greatly to this and make this book stand out against its peers. Unfortunately it's not all roses and the authors do fall down in several chapters, leaving the reader with vast swathes of near impenetrable text that has little clinical relevance. It is a real pity that these chapters were not worked on more and brought up to the standard of the others. Well, maybe that's what we'll get in the fifth edition!

      Unlike a large proportion of medical texts, this book is actually fairly cheap, weighing in at £22.90 with free delivery on Amazon.co.uk. This book holds its value pretty well and can be sold on to other medical students for close to full price if you keep it in good nick. A steal at that price!

      I'd like to give this a five star rating but some poor chapters just drag it down too much. Four stars overall, lose the poor ones however and you've got a fantastic resource for your medical education.

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