This document provides an overview of neurological localization and pathology. It discusses the extrapyramidal system, cerebellum, blood supply and drainage of the brain and spinal cord, cranial nerve nuclei, motor and sensory pathways, spinal tracts, the autonomic nervous system, common CNS pathologies, and practical considerations for neurological localization including involved systems, laterality, onset, progression, and circumstances.

1. Localization in Neurology- 1
Anatomical & pathological
correlation

2. Brain functions

3. Extrapyramidal system
 Afferent-
 Caudate nucleus
 Globus pallidus
 Efferent-
 Putamen
 Substantia nigra
 Subthalamic nucleus

4. Cerebellum
 Coordination
 Vermis- axial &
Lobes- I/L appendicular
 3 peduncles
 Superior- midbrain- efferent
 Middle- pons- afferent
 Inferior- medulla- afferent

5. Blood supply
of brain
 Internal carotid
 MCA
 ACA
 Subclavian artery
 Vertebral artery-2
Ant. spinal artery-1
PICApost. spinal artery-2
 Basilar artery-1
AICA
SCA
PCA
 Circle of Willis
 AC-ACA-MCA-PC-PCA

6. Blood supply

7. Blood supply

8. Venous drainage of brain

9. Blood supply to spinal cord
 Anterior 2/3rd
-
ASA
 Posterior 1/3rd
-
PSA

10. Cranial n.
nuclei
 Midbrain
III, IV
 Pons
V-VIII
 Medulla
IX-XII

11. Motor pathways

12. Sensory pathways

14. Spinal tracts

15. Tracts
 Motor-
 Corticospinal- cross at medulla
Medial Lateral- C.T.L.S
 Sensory-
 Spinothalamic- pain & temperature-
cross at spinal level
Medial Lateral- C.T.L.S
 Posterior column- touch, position, vibration-
cross at medulla
Medial Lateral- S.L.T.C

16. Motor & sensory units

17. Autonomic nervous
system
 Sympathetic
Thoraco-lumbar
 Parasympathetic
Cranio-sacral
(III, VII, IX, X cranial n.
have parasympathetic nuclei)

18. ANS
 Involuntary, independent
 Located outside cerebrospinal axis
 Most organs have both S & PS supply;
adrenal, hair follicles, sweat glands, blood vessels- S
supply only
 Lateral horn  Ganglia  Organ
pregang. fibres postgang. fibres
all Ach S-NE, PS-Ach
 Central regulation-
frontal lobe, limbic system, hypothalamus

19. CNS- pathology
 Vascular- infarct or
hemorrhage
 Infection- myelitis or
encephalitis
 Abscess
 Meningitis
 Trauma
 Demyelination
 Degenerative
 Tumor/SOL
 Congenital or
hereditary
 Nutritional
 Metabolic
 Toxins/Poisoning
 Psychogenic

20. Practical localization
 Is CNS involved?
 At what level- cerebral cortexmuscle?
 What system(s) is/are involved?
 Consciousness, language, vision
 Motor function, coordination
 Pain/temperature, proprioception/vibration
 Process- focal/multifocal/diffuse?
 Lateralization- Left/Right/bilateral?
 Onset, progression & course?

21. Practical pathology
 Onset-
 Acute- vascular/electrical
 Subacute- demyelinating/inflammatory
 Chronic- structural/degenerative
 Course-
 Self-limiting- vascular
 Paroxysmal- electrical/demyelinating
 Progressive- compressive/degenerative
 Circumstances-
 Preceding viral infection- demyelinating
 Preceding trauma- structural
 Peripartum- venous thrombosis etc.