Book Reviews

Color Atlas of Brainstem Surgery

Spetzler RF, Kalani MYS, Nakaji P, Yagmurlu K. Color Atlas of Brainstem Surgery. Thieme; 2017; 416 pp; 850 ill; $249.99

cover of Spetzler

This recent publication is a unique work that emphasizes the structural and functional anatomy of the thalamus and brainstem and provides guidance for accessing these regions surgically for intrinsic lesions. The print atlas is accompanied by a large collection of online media, including animations and narrated surgical videos.

The book opens with an overview of anatomy, beginning with surface structures and perpendicular sections of whole fixed brains and progressing through focused dissections. To clarify specific relationships, it strategically incorporates diagrams of deep venous anatomy and cisterns around the brainstem. It summarizes the function and location of the long fiber tracts at the level of the cerebrum, midbrain, pons, medulla, and spinal cord, reviewing the clinically significant deficits incurred with lesions at each level. The discussion then integrates these concepts to introduce the safe entry zones of the brainstem, identifying both surface and deep structures that must be avoided. Fixed tissue dissections of varying depth demonstrate the three-dimensional relationships of adjacent tracts and nuclei. Full-color illustrations and dissection views of the associated vasculature are accompanied by axial slices depicting the territories of arterial supply. The combination of detailed sketches and meticulous dissections helps the reader bridge the conceptual gap between cross-sectional images and a surgeon’s view of the deeper structures that are imminently transgressed. The anatomy section finishes with a summary of the skull base foramina and traversing cranial nerves.

The next section of the book specifically describes the safe entry zones and nearby landmarks, with illustrations that depict the surface and cross-sectional anatomy of each zone. Some of this content is outlined in the preceding chapter, but this section provides a detailed rationale for the use of the safe …

Chordomas: Technologies, Techniques and Treatment Strategies

Necmettin Pamir M, Al-Mefty O, Borba LAB. Chordomas: Technologies, Techniques and Treatment Strategies. Thieme; 2017; 256 pp; 400 ill; $199.99

Cover of Necmettin Pamir

When I was asked to review this book, I was a bit apprehensive. I questioned the rationale of reviewing an entire book dealing with a tumor I encounter only a handful of times a year. As a neuroradiologist with passion for skull base imaging, I would have found more practical use out of a book discussing more commonly encountered diagnoses such as schwannomas or meningiomas. However, to my pleasant surprise, this was an outstanding book to review and by far one of the best reads in the last few years.

The book, a product of the collaboration of over 50 contributors from 6 different countries, tackles a rare but challenging entity. It is a well-organized book that is divided into 4 parts.

Part 1. Definition, History, Demographics, Pathology and Pathogenesis: Eight chapters describe historic aspects of this disease and address a wide variety of topics ranging from descriptive epidemiology, to embryology of the notochord, to pathology, and even to cytogenetic and molecular biology of chordomas.

Part 2. Diagnosis of Chordomas: As a neuroradiologist, this was of specific interest to me. It consists of 3 chapters. The first 2 are about radiologic findings and differential diagnosis of chordomas at the skull base and spine, respectively. The third chapter deals with molecular imaging of chordomas.

Part 3. Surgical Treatment of Chordomas: This is the largest section of the book. It tackles the surgical techniques and approaches that are currently available, their indications, advantages, and limitations. Conventional techniques as well as new, innovative technologies are eloquently described.

Part 4. Special Topics in Chordomas: In this section, a variety of miscellaneous topics are discussed, including radiation therapy, recurrent tumor management, and even outcomes/quality …

Neurosonology and Neuroimaging of Stroke: A Comprehensive Reference, 2nd Edition

Valdueza JM, Schreiber SJ, Roehl J-E, Connolly F, Klingebiel R. Neurosonology and Neuroimaging of Stroke: A Comprehensive Reference. 2nd ed. Thieme; 2017; 768 pp; 1305 ill; $224.99

Cover of Valdueza

Neurosonology and Neuroimaging of Stroke, written by 4 neurologists and 1 neuroradiologist, is an exhaustive review of stroke imaging, with a special emphasis on vascular ultrasound. As stated in the preface, it is based on the combined teaching experience gained by the authors over the last 15 years.

The book is divided in 2 parts. “Part A: Principles and Rules,” the first third of the book, is dedicated to basic ultrasound principles, with a focus on ultrasound vascular anatomy, blood flow hemodynamics, stroke pathogenesis, and a comprehensive presentation of intracranial and extracranial vascular pathology. It ends with an overview of current neuroradiologic vascular imaging techniques such as DSA, MRA, and CTA. In each chapter, schematic diagrams, pictures, and multimodality images, which are thoughtfully labeled and adequately described, beautifully depict the subject matter. The supplemental online material includes high-quality videos that illustrate both arterial and venous ultrasound examinations.

“Part B: Case Histories” is a collection of 45 cases, each of which is presented in the same format: a case presentation, initial neuroradiologic findings, suspected diagnosis, questions to answer, initial neurosonologic findings, clinical course, final diagnosis, and discussion. The cases range from commonly encountered entities such as atherosclerotic disease, to rarer and more elusive diagnoses such as arteriovenous dural fistula, postpartum angiopathy, and diffuse cerebral angiomatosis. Each case is accompanied by high-resolution ultrasound images, which are exquisitely correlated to other cross-sectional modalities and are well-annotated. Finally, the discussions are well-written and thorough, with a strong emphasis on clinical management.

In the authors’ own words, this book is aimed at all doctors—in particular at neurologists, neurosurgeons, internists, angiologists, and neuroradiologists who treat neurologic or …

AOSpine Masters Series, Volume 8: Back Pain

Roberto Vialle L, ed. Wang JC, Lamartina C, guest eds. AOSpine Masters Series, Volume 8: Back Pain. Thieme; 2016; 230 pp; 133 ill; $119.99

Cover of Roberto Vialle

AOSpine Masters Series is a collection of 10 volumes covering various topics of the spine. This review will cover Volume 8: Back Pain. One of the most common chief complaints encountered by our family physicians and orthopedic surgeons is back pain. At times, treating back pain is very challenging to our healthcare providers and places a significant social and economic burden on our healthcare system. This book reports that the prevalence of back pain ranges from 70–85%.

This publication is organized into 16 chapters covering a broad range of topics that include social aspects, physical exam, imaging, and treatment. There are also specific chapters dedicated to specific pathology, including that of the sacroiliac joints, myopathies, neuromuscular disease, and infection. Additional chapters discuss back pain in pediatric and adult populations.  Within each chapter, the subtopics are clearly identified and tables are nicely labeled. One neat feature of each chapter is the “pearls and pitfalls,” which provides bolded teaching points.

The chapter on imaging provides a broad overview of indications, imaging techniques, and modalities available for back pain. The chapter provides a few pictorial examples of pathology affecting the spine.  The imaging discussed in this chapter would be useful for the general practitioner, as it explains the algorithm behind radiographic work-up of back pain.  This chapter also further explains the pros and cons of imaging modalities such as plain films and MRI.  The images are of good size and quality.

At the end of each chapter, the authors cite the references used, making it easy to correlate the chapter content. The majority of the references are from peer-reviewed journals. One good feature is the authors’ highlighted “5 …

Fundamentals of Neurology: An Illustrated Guide, 2nd Edition

Mattle H, Mumenthaler M. Fundamentals of Neurology: An Illustrated Guide. 2nd ed. Thieme; 2017; 456 pp; 567 ill; $79.99

Cover of Mattle and Mumenthaler

Fundamentals of Neurology: An Illustrated Guide is an introductory textbook of clinical neurology. It provides a comprehensive overview of common neurologic and muscular disorders, with numerous supporting illustrations that serve to further clarify the content of this book. The intended audiences are medical students, residents, and practicing clinicians. Indeed, the textbook’s format, concise language, and straightforward illustrations will appeal to physicians of all training levels.

The textbook’s organization is easy to follow, starting from the first page where each chapter is listed and assigned a color that is used for the remainder of the book to designate the corresponding pages of the chapter. Furthermore, the material of each chapter is divided in a way that is easy to digest through the use of sections, which begin by summarizing the key points, and subsections, which have the important ideas highlighted. This approach allows the reader to use the textbook either for detailed studying or for a quick reference. Moreover, the tables, diagrams, and radiologic images are of high quality and are well annotated. In fact, if time is a limiting factor, the reader can still gain a strong understanding of the most important information by just reviewing the provided illustrations.

The textbook’s content primarily provides a clinical approach to understanding various neurologic disorders, with only a superficial focus on diagnostic radiology, especially when compared with more well-known textbooks written for the field of neuroradiology. While the initial chapters concentrate on techniques for obtaining a good patient history and physical exam, as well as ordering appropriate ancillary tests, the second half of the book discusses symptoms and common neurologic disorders in a way that neuroradiologists will also find relevant. For example, there …

MR Neuroimaging: Brain, Spine, Peripheral Nerves

Forsting M, Jansen O. MR Neuroimaging: Brain, Spine, Peripheral Nerves. Thieme; 2017; 600 pp; 1399 ill; $224.99

Cover of Forsting and Jansen

MR Neuroimaging: Brain, Spine, Peripheral Nerves by Michael Forsting and Olav Jansen is an English translation of the second German edition of MRT des Zentralnervensystems, which was published in 2014. This 600-page hardcover book intends to serve as a reference manual for neuroimaging interpretation.

As suggested by the title, the book is divided into 3 sections: 1) brain, 2) spinal cord, and 3) peripheral nervous system.

The first 2 sections have an introductory chapter on anatomy. MRI appearance of different structures is the focus, with several illustrations that lay a good foundation for the material to come. The chapters conclude with an abridged description of normal variants, which, if more inclusive, could have further benefitted a practitioner less familiar with neuroimaging.

The chapter on brain anatomy is followed by 9 others covering a broad range of common and unusual conditions. Pediatric neuroimaging is dealt with in a dedicated chapter.

Imaging of the spine is covered in 6 further chapters.

The third section includes a concise discussion of magnetic resonance neurography and neuropathies in the final 8 pages.

Most pathological conditions are described under the subheadings of epidemiology, clinical manifestations and treatment, pathology, MRI findings, and differential diagnosis. This systematic approach, paired with a straightforward index, makes it very easy to navigate the text.

The highlight of this book is the excellent quality of the images it uses to depict the pathology described. Multiple sequences and planes are routinely used to characterize the findings. The annotations are descriptive and easily comprehensible. The authors often discuss the best techniques and ideal sequences for optimal evaluation of imaging findings. Most pages are studded with boxes labeled “Note,” “Tips and Tricks,” or “Pitfall” and highlighted …

Elastography: A Practical Approach

Barr RG. Elastography: A Practical Approach. Thieme; 2016; 200 pp; 400 ill; $119.00

Cover of Barr

This comprehensive book encompasses the principles and techniques used in performing elastography under ultrasound guidance. The stiffness or softness of tissue measured by this innovative technique aids radiologists and clinicians in diagnosing various disease conditions, including cancer and inflammation. The changes (including desmoplastic reaction) induced in tissues due to these pathologic processes alter the compressibility and deformation of the surrounding stroma, which are what elastography measures. Given that stiff lesions are more likely to be malignant, the implications of this application can be huge in terms of lesion characterization and management.

The book begins with an introduction to elastography, including shear-wave and strain; the former provides a quantitative assessment and the latter a qualitative assessment of elastography. The physics and technical background are explained in simple and reader-friendly terms. The techniques required to obtain optimal images with the various methods are discussed in a language that is easy to understand. The text is accurate and concise. Case studies that demonstrate the targeted use of elastographic findings by specific pathologic processes are discussed. Important points, such as precompression, descriptions of the imaging patterns, limitations, and artifacts, are covered for ultrasound machines provided by common vendors in the market. There are many illustrations and diagrams to enhance and enrich readers’ experience. The images are appropriately labeled, helpful, and easily interpretable. The references are comprehensive, current, accurate, and obtained from scholarly publications. Two of the unique features of this book are the “tips and tricks” and the “artifacts and pitfalls” sections at the end of each chapter.

The chapters are written by leading authorities around the world on the subject of elastography and its applications in various organ systems of the body. The chapters include step-by-step descriptions of the …

Questions and Answers in MRI

Elster AD. Questions and answers in MRI. MRI Questions Web site.

For radiologists who have devoted their lives and education to medical diagnosis, trying to grasp the advanced physics behind modern MR imaging is like a foray into another world with a completely exotic language. Resources and texts are numerous, but many are written by those who primarily have a formal physics education and write in a language unfamiliar to those without the same background. Out of all the available resources, one shining beacon lights the path to understanding.

With his website, Dr. Allen Elster, MD, FACR translates the language of MR imaging, beautifully explains complex concepts, and simply transforms the foreign into the familiar. Whenever I have a question about the physics of MR imaging as it relates to my daily radiology practice, I consult the website and almost always have an answer within 5 minutes of reading. While covering numerous topics in MR imaging, Dr. Elster strives to fill each article with practical information that is applicable to optimizing patient imaging. This is why his website stands out among all the others; he is able to take the complexity of MR imaging and distill the information to that which is most valuable for the daily practicing radiologist. Included at the end of each page are references, many of which are interesting historic and landmark papers in the development of MR imaging.

The site design is beautifully practical and it often feels as though he has anticipated the next questions of the reader and placed links to relevant information. All content is free to use and frequently updated with new sections.

The next time a question arises in the reading room about the principles behind an MR imaging sequence, the cause of an artifact, or the …

Vertigo and Disequilibrium: A Practical Guide to Diagnosis and Management, 2nd Edition

Weber PC. Vertigo and Disequilibrium: A Practical Guide to Diagnosis and Management. 2nd ed. Thieme; 2016; 248 pp; 167 ill; $129.99

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The second edition of Vertigo and Disequilibrium: A Practical Guide to Diagnosis and Management, authored and edited by Dr. Peter C. Weber, takes on the challenging task of summarizing the diagnosis, pathophysiology, and treatment of the various etiologies of vertigo and disequilibrium in a mere 230 pages. Although vertigo and disequilibrium are relatively common complaints, their work-up is a daunting and intimidating task for most physicians. Dr. Weber describes the vestibular system as a poorly understood “black box” because of limited exposure to its anatomy and pathophysiology during medical school and residency training. This book successfully addresses common misunderstandings and lays out a systematic approach to the assessment, diagnosis, and treatment of various etiologies accounting for vertigo and disequilibrium. The chapters are short, concise, clear, well-written, well-organized, and supplemented with helpful figures and tables, as well as updated references for more in-depth reading. The book ends with an appendix of practical frequently asked questions, which would be of use to both physicians and patients alike. The supplemental online videos, which have been expanded from the first edition, provide examples of common procedures, treatment maneuvers, physical examination techniques, and signs.

The first 6 chapters lay the groundwork for the rest of the book by succinctly summarizing important aspects of the medical history, physical examination, computerized testing, radiology work-up, anatomy, physiology, and laboratory testing in patients with vertigo and disequilibrium. At the beginning of Chapter 1, Dr. Weber stresses the paramount importance of a medical history: “The diagnosis of a patient with vertigo or dizziness can almost always be ascertained 80% of the time by taking an accurate history.” In the very first paragraph of the book, the author …

Spine Surgery: Tricks of the Trade, 3rd Edition

Vaccaro AR, Albert TJ, eds. Spine Surgery: Tricks of the Trade. 3rd ed. Thieme; 2016; 462 pp; 400 ill; $199.99

Cover of Vaccaro

Summarizing and organizing all aspects of spine surgery is a daunting and arduous task. The spinal column can provide a variety of pathology to the surgeon while offering particular vulnerability in the trauma setting, necessitating urgent or emergent attention. This text is authored by 2 of the most reputable spine surgeons in the world, which offers the reader some confidence as they navigate through the chapters. The other contributors are also recognized as experts in the subject category they are describing.

The text consists of 21 distinct sections providing organization and appropriate categorization of all aspects of spine surgery. Within these 21 sections, 112 chapters highlight the finer details of each topic and procedure. The chapters are each very easy to read and understand, no matter the level of one’s training or discipline. These chapters are all structured with a similar foundation and schematic so that the readers of this text can anticipate the areas of focus from page to page.  Uniformly, each of the 112 chapters includes a description of the procedure discussed, indications/contraindications, and special considerations. Each also highlights key procedural steps and shares the experiences of other surgeons to help avoid pitfalls and ensure technical completion of the surgical objective.

As an owner of both the second and third editions, I can personally attest to the quality improvements of this resource. Color illustrations, charts, and photographs are featured in every chapter, as opposed to only black and white pictures in the previous edition. Moreover, this edition provides online access to a multitude of videos that demonstrate the technical aspects of these operations, which were filmed in the operating room or on cadavers. Furthermore, the scope of …