Abstract
How many times have we heard a lecturer rattling off several anatomical sites in the brain, and we the listeners are uncertain where these are or what is their (supposed) function? I often find myself in this situation, determined to look up Gray's Anatomy when I get home – but fail to do so. This small ‘flexibook’ is the answer to failed self-promises.
This easily held book is beautifully produced with print on left hand pages and clear, simple, coloured illustrations on the right. Among the topics are thalamic nuclei and their cortical projections, the hypothalamus – structurally and functionally, the limbic system, neuroendocrine axes, the autonomic nervous system, neurones and neuroglia, blood–brain barriers, electrical and chemical exchanges at synapses and the neuromuscular junction, special senses, damage and repair in the nervous system, besides the more usual motor and sensory systems and brain-stem structures. In addition there are four pages of salient references.
The senior author being the non-medical director of the endocrine unit at St Thomas' Hospital, London (UK), it is not surprising that the hypothalamus-pituitary axis gets special attention. Anatomy, physiology and biochemistry are clearly illustrated showing the interplay of stimulating and feedback mechanisms, as well as peptides, endorphins, encephalins among other neurotransmitters.
Of interest to Cephalalgia readers are the two sensory nuclei of the trigeminal: the descending branch transmits pain — highly significant in migraine; could the dorsal nucleus transmitting position sense and touch, be the pathway in those headache patients who say ‘It is not a pain doctor, it's a pressure’?
The illustration of the homunculus lying over the sensory cortex shows the shoulder and neck are adjacent to the trunk; but the and lips are 4 cm lower in the diagram, at least 10 cm in the human brain. In the migraine aura, however, numbness begins at the fingers, then spreads up the arm to the shoulder, extending to the face and lips, in some bilaterally round the mouth. If Leao's phenomenon is the explanation then a more correct description would be Leao's jumping depression if the lips are involved unilaterally, and flying depression when bilateral.
This book can be recommended without reservation. Furthermore, the authors, illustrator, printer and publisher, all merit our congratulations and our thanks.