By Daniel B. Hier, MD, MBA, FAAN, AAN.com Education Editor (U. of Illinois at Chicago), and Mike Petkovich
Whether they take the form of CT, PET, or MRI scans, gross pathologic images, microscopic images, or patient videos, neuroimages are critical to neurologic education and research. Neurologic images may encompass normal brain anatomy or a variety of disease states, evaluations, and diagnoses. This article presents a number of neurology-related websites featuring high-volume, high-quality image resources.
Websites containing neuroimages on the Internet are plentiful and diverse. Many image resources are available through mainstream search engines (such as Google.com or Yahoo.com), neuroscience directories and libraries, or atlases and videos—all archived on the web. Unfortunately, reliability and quality are mixed, depending on the resources chosen for an image search. This article presents samples of neurology-related websites with high-volume, high-quality image resources.
Neuroimages available through search engines often pose problems for researchers, because many of the held images are:
Instead of taking chances on the unrefined selection of images available through general web searching, researchers often turn to neuroscience directories or libraries for targeted searches. Some of the better examples of these resources are listed below.
AAN Digital Resource Library (DRL)—The Distance Learning Subcommittee of the AAN has created an AAN Digital Resource Library. The DRL is a repository of images and videos for the educational use of AAN members. Current content includes material from Continuum® and Neurology®. Additions are planned in the near future.
Neuroland: Clinical Neurology Information for Professionals—Maintained and supported by Charles Tuen, MD, through the Methodist Medical Center in Dallas, Texas, this site provides links to roughly 20 neurology websites for physicians and health care professionals. In addition to neuroimages, Dr. Tuen's website provides links to online medical books and journals, practice hints, medication information, and practice guidelines.
Hardin MD: Nervous System / Neurology—This site, as part of the Hardin Library for the Health Sciences maintained by the University of Iowa, presents a list of links for images of the nervous system, the brain, and various neurological diseases.
Karolinska Institutet—The Karolinska Institutet is one of the largest medical universities in Europe, and is Sweden's largest center for medical research and education. The website has links to 30 websites from Europe and the United States. Additional links may be found elsewhere on the site.
The Neuro-Ophthalmology Virtual Education Library—The Neuro-Ophthalmology Virtual Education Library (NOVEL) is maintained by The North American Neuro-Ophthalmology Association (NANOS). NOVEL is a collection of images, videos, animations, and documents for neuro-ophthalmology professionals, educators, students, and patients. Materials are available on normal eye structure and function and a variety of diseases and disorders.
The Whole Brain Atlas—This website is maintained by Keith Johnson, MD, and J. Alex Becker, PhD, at the Harvard Medical School. The atlas contains a variety of MRI and CT images related to stroke, dementia, and other neurologic conditions.
Internet Stroke Center—Another good source of neuroradiology images is the Internet Stroke Center, maintained by the Washington University School of Medicine. Images on this site are copyrighted; however, they can be used for educational purposes upon obtaining email permission from the Center.
Neuromuscular Disease Center—Washington University maintains an extensive library of nerve and muscle images. The collection includes magnetic resonance images, nerve and muscle biopsy images, as well as line diagrams and EMG recordings.
Health Education Assets Library—The Health Education Assets Library (HEAL) was established as a joint effort of the medical schools of the University of Utah, the University of Oklahoma, and UCLA. HEAL is designed to provide a broad array of materials to health science educators. The library's neurologic resources are a small (but substantial) portion of the collection.
The HEAL library contains two types of contributions. "Affiliate collections" are from institutions that have formed partnerships with HEAL. Users can access these collections through the HEAL interface. The "HEAL Reviewed Collection" is a set of high-quality assets that have been submitted by individuals. Contributions are evaluated and catalogued by curators. The contributors retain copyright, but contributions are licensed for educational use by the Creative Commons license [link to: creativecommons.org]. Free registration is required to use the site.
A variety of high-quality atlases of normal brain anatomy can be found on the Internet.
Braininfo—This is an innovative website housed at the University of Washington. Users may search the atlas by term and identify different brain areas in a number of views, including MRI and stained brain sections.
The Digital Anatomist: Interactive Brain Atlas—This is a fully digital brain atlas that uses colorized digitized images to highlight important aspects of brain anatomy and their underlying anatomic pathways. The Digital Anatomist is the work of John W. Sundsten, PhD, in the Department of Biological Structure, University of Washington.
The Human Brain Atlas—Michigan State University maintains this robust atlas, which includes coregistered MRI images and stained brain sections.
Sushi—Sushi is the creation of computer scientist Tom Conlin at the Department of Computer Sciences at the University of Oregon. It provides an easy, fun-to-use way to explore digitized images of the human brain in three dimensions. Data is derived from the National Library of Medicine's Visible Human Project®.
Synapse Web—An excellent source of ultrastructural (electronic microscopic) images of axons, dendrites, and neurons is Synapse Web, the creation of principal investigator Kristen M. Harris, PhD, at the University of Texas. The site, which includes elegant reconstructions of axonal and dendritic trees, is funded jointly by the National Institute of Mental Health and the National Institute of Drug Abuse.
University of Arkansas Neuroscience Atlas—The University of Arkansas maintains an excellent atlas of normal gross anatomy of the brain and spinal cord.
A few websites have useful collections of videos, including demonstrations of neurologic examination and videos depicting various diseases and conditions.
An Interactive Online Guide to the Neurological Examination—This website is the creation of Hal Blumenthal, MD, PhD, and is the online companion to his book, Neuroanatomy through Clinical Cases. The website contains videos of each part of the neurologic examination.
NeuroLogic Exam—This is a spectacular website on the neurological examination. A joint effort of the University of Nebraska and University of Utah schools of medicine, the site integrates video on the neurologic examination with neuroanatomic diagrams and short lectures commenting on how the examination correlates with neuroanatomy. The site is the creation of Paul Larsen, MD, from the University of Nebraska, and Suzanne Stensaas, PhD, from the University of Utah. The site includes video of both normal and abnormal neurologic findings.
Wright State Neurological Teaching Videos
High-quality videos of patients with a variety of neurologic conditions, including cerebellar disease and Parkinson's disease, can be viewed at the Wright State Neurological Teaching Videos library. These videos are also located in the HEAL image library. Free registration is required at both the HEAL site and the Wright State University site, in order to view the videos.
We are interested in learning about other sites that you find useful or interesting. Please contact Daniel Hier, MD, MBA, FAAN (firstname.lastname@example.org) or Mike Petkovich (email@example.com) with the web addresses of your favorites.
Dr. Hier has received personal compensation for medical legal consulting and for consulting to legal firms regarding medical malpractice issues within the past 24 months. In addition, he has received personal compensation in an editorial capacity for AAN.com and MDnetguide and has given expert testimony in medical malpractice cases.
Mike Petkovich has nothing to disclose.