Chapter 1

About this Book and How to Use it

The principal purpose of this book is to act as a quick revision tool for medical students approaching finals or other undergraduate neurology/neurosurgery exams. Although the book is intended as a quick revision tool, using it diligently and devoting time to understanding the basic concepts outlined herein will allow you to neurologically flourish rather than simply pass exams. The book is designed for both the newer type of written exams, including multiple choice questions (MCQ) as well as the extended matching questions (EMQ), and traditional exams requiring long and short answers. This book is also designed to prepare you for the Objective Structured Clinical Examinations (OSCE); in particular, Part II is geared towards this purpose.

The book is divided into three parts. Part I gives you the necessary basic principles and facts essential for building a foundation in clinical neurology/neurosurgery at an undergraduate level. Only clinically relevant neuroanatomy is presented along with an introduction to the topics of neurological history, examination and investigations. In particular, we have tried to simplify neuroradiological concepts and presented the rationale for using different imaging modalities.

Part II is very much geared towards the OSCE and the viva voce exams in finals. This section consists of chapters dealing with various presenting complaints. Lists of focussed and discriminating questions for determining the important differential diagnoses are included in these chapters along with tables listing the relevant disease entities in order of incidence. Please note, however, that you will also be expected to ask other relevant questions not listed in the chapters while taking a detailed history, including past medical history, drug history and social history. Additional important clinical information for each presenting complaint is included. The tables of potential differential diagnoses are supplemented by information on basic investigations and management. Again, in an exam setting you will have to be guided by the clinical information and suggest a list of focussed and relevant investigations! This part of the book can also act as a worthy quick reference on wards and in clinics.

Part III presents the important clinical neurological and neurosurgical conditions with focussed pertinent clinical information. Neurological topics are presented first followed by neurosurgical topics with the exception of the chapter on subarachnoid haemorrhage, which is included under ‘stroke’. Part III like other parts is interspersed with sentences beginning with ‘Remember . . .’ and designed to highlight key facts from the chapter. At the end of each chapter there is a list of common differential diagnoses (up to a maximum of four–five) for the particular condition described. General clinical details are provided, including, where applicable, information that can be used to distinguish between or exclude the alternative conditions. This should be of particular help for the EMQ section of the exam and will also prove useful in the OSCE when presenting a list of potential differential diagnoses.

Some of the chapters in the book may not strictly follow the format as laid out above and will generally be due to the nature of the topic and thereby the limitations of presenting it in a specific format.

We hope that the format; organisation and simple language employed will facilitate quick and effective revision and will help you perform well in all sorts of undergraduate examinations. Moreover, we trust this book will permit a better understanding of the basic concepts underpinning neurology and neurosurgery and thus provide a firm basis upon which to build your clinical neurological/neurosurgical expertise as you journey through your medical career.

Good Luck!