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第12章:临床神经学的解剖学基础。

Chapter 12: the anatomical foundations of clinical neurology.

作者信息

Bentivoglio Marina, Mazzarello Paolo

机构信息

Department of Morphological and Biomedical Sciences, Faculty of Medicine, University of Verona, Verona, Italy.

出版信息

Handb Clin Neurol. 2010;95:149-68. doi: 10.1016/S0072-9752(08)02112-X.

Abstract

The chapter provides an itinerary of knowledge on nervous system anatomy as one of the pillars of clinical neurology. The journey starts from the Renaissance explosion on the approach to the human body, its functions and its diseases, dealing with the seminal contributions of Leonardo da Vinci and Vesalius. The itinerary proceeds through the contributions of the 17th century, especially by Thomas Willis and the pioneering investigations of Marcello Malpighi and Antony van Leeuwenhoek, and onto the 18th century. The itinerary thus leads to the progress from gross anatomy to the microscopic investigation of the nervous system in the 19th century: the reticular theories, the revolution of the neural doctrine and their protagonists (Camillo Golgi and Santiago Ramón y Cajal), which initiated the modern era of the neurosciences. The chapter also includes sections on the contributions of developmental neuroanatomy to neurology, on the history of tract tracing, and on the cytoarchitecture of the cerebral cortex. The never-ending story of the anatomical foundations of clinical neurology continues to evolve at the dawn of the 21st century, including knowledge that guides deep brain stimulation, and novel approaches to the anatomy of the living brain based on rapidly developing neuroimaging technology.

摘要

本章介绍了神经系统解剖学的知识历程,它是临床神经病学的支柱之一。这段历程始于文艺复兴时期对人体、其功能及疾病研究方法的蓬勃发展,涉及列奥纳多·达·芬奇和维萨里的开创性贡献。历程接着讲述了17世纪的贡献,特别是托马斯·威利斯的贡献以及马尔切洛·马尔皮基和安东尼·范·列文虎克的开创性研究,然后进入18世纪。这样,这段历程引领我们看到了19世纪从大体解剖学向神经系统微观研究的进展:网状理论、神经学说的革命及其倡导者(卡米洛·高尔基和圣地亚哥·拉蒙·伊·卡哈尔),这些开创了神经科学的现代时代。本章还包括发育神经解剖学对神经病学的贡献、神经束追踪的历史以及大脑皮质的细胞构筑等内容。临床神经病学解剖学基础这一永不停歇的故事在21世纪初仍在不断发展,包括指导深部脑刺激的知识,以及基于快速发展的神经成像技术对活体大脑解剖学的新方法。

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