Hemorrhagic and Ischemic Stroke is a multidisciplinary, 584-page hardcover textbook which discusses the medical, radiological, surgical, and image-guided interventional aspects of this topic. It is co-edited by 2 neurosurgeons (Drs. Bendok and Batjer), a neurologist (Dr. Naidech), and a neuroradiologist (Dr. Walker). The imaging input into this text is substantial, and radiology abounds throughout the book, even in areas where imaging is not the primary topic of the section. A significant portion of the text is devoted to Radiology—Section II: Imaging Considerations. Authors include many prominent in neuroradiology so the reader is assured of up-to-date and relevant information.

One is immediately struck by the fanciful cover, apparently drawn by the artist Jennifer Pryll. It is enticing and attempts to summarize (a picture in this instance is worth many more than a thousand words) all sorts of aspects of surgery, imaging, and interventions. You gotta see it.

There are 4 major sections, each section with multiple chapters: Medical and Critical Care Considerations (6 chapters); Imaging Considerations (6 chapters); Open Surgical Approach (17 chapters); Neurointerventional Approaches (11 chapters). While all chapters should be of interest to a neuroradiologists, Chapter II commands most of our attention. Here, separate areas deal with Hemorrhagic and Ischemic Stroke relative to (1) CT, (2), MR (3) PET, (4) Ultrasound, and (5) Neuroangiography. There is a sixth chapter on Promising Developments in Stroke Imaging.

These chapters contain high quality imaging with up-to-date protocols in advanced stroke imaging. Tables abound throughout these chapters, so one gets for example a quick summary of perfusion weighted imaging parameters (CBV, CBF, etc., along with an adequate examples), MRA, the time evaluation of blood on MR, parameters for assessing carotid disease by ultrasound—again with abundant examples, guidelines for TCD, along with many more. The section ends with a short but beautiful chapter on the future of imaging in stroke by Drs. Rowley, Turski, and Strother. Besides the authors perspective on where stroke imaging/analysis is heading, we are shown new entities (or at least new to this reviewer) such as time resolved MRA using HYPR-highly constrained projection reconstruction. [“Y” fits into that acronym by the end of word highly]. We also see the result of phase contrast MRA yielding hemodynamic date.

For the neurointerventionalist there will be great interest in the chapters on Open Surgical approaches and also, obviously, in the 155-page section on neurointervention. In this latter section, the whole gamut of procedures is covered, including thrombolysis/thrombectomy, angioplasty/stenting, aneurysm coiling, management of dissections, embolization of intracranial AVMs and DAVFs, and Spinal AVMs and DAVFs. These chapters nicely complement and add to material that appears earlier in the text on open surgical perspectives of these abnormalities.

Please note that added to all of this written and illustrative material is a registration and code which allows the reader to access surgical/interventional videos of 10 different operative procedures such as AVM surgery, ECA-ICA bypass, aneurysm coiling, spinal dural fistula embolization, and more. These extra features enhance significantly the value of this textbook.

As a final note, one has to admire the many artist drawings which are so helpful to the reader’s understanding, particularly with issues related to surgery.

To this reviewer, Hemorrhagic and Ischemic Stroke is the best single publication on this topic produced to date. It is recommended in the highest terms to all neuroradiologists; in fact, it should be part of the personal library of anyone who deals with stroke (and what neuroradiologists doesn’t?).

]]> http://www.ajnrblog.org/2012/02/01/hemorrhagic-and-ischemic-stroke-medical-imaging-surgical-and-interventional-approaches/feed/ 0 http://www.ajnrblog.org/2012/01/30/fighting-for-our-health/ http://www.ajnrblog.org/2012/01/30/fighting-for-our-health/#comments Mon, 30 Jan 2012 20:20:02 +0000 bookreviews http://www.ajnrblog.org/?p=5765 Kirsch R.  Fighting For Our Health.  The Rockefeller Institute Press 2012, 416 pages, $19.95.

Fighting For Our Health provides a left-sided perspective on the processes and powers that led to the passage of the Patient Protection and Affordable Care Act in March of 2010.  The author is neither an academic nor a health care provider.  He has spent much of his recent career working with an advocacy organization called Health Care for America Now that is headquartered on K street in Washington, D.C., backed by a coalition which includes grass roots support, powerful unions, and wealthy backers.

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With the ever-increasing availability of high-field strength MRI scanners, the demand for clinical functional MRI studies is outstripping the supply of formally trained individuals to fill this need.  fMRI: Basics and Clinical Applications seeks to address this critical need by providing the interested novice with the tools necessary to develop such a program.

The 181-page book is organized into two large sections that first review the basics of fMRI and then discuss various clinical applications.  The contributing authors are internationally distinguished experts in the fields of radiology, neurology, and neurosurgery.  The chapter topics are well organized and begin with an introductory overview of the challenges intrinsic to building a clinical fMRI program followed by a well-illustrated chapter reviewing neuroanatomy and cortical landmarks.   The neuroanatomy chapter is important, since fMRI interpretation requires a more in depth understanding of neural function and structure than radiologic interpretation of structural MRI. Missing from this chapter, however, is the inclusion of 3-D renderings that are now widely available.  Other topics reviewed in the Basics section include spatial resolution of fMRI techniques, a discussion on perfusion vs. blood oxygen level dependent (BOLD) imaging, the electrophysiologic basis underlying fMRI, and the pros and cons of high-field and ultra-high field MRI.  The Basics section ends with a chapter called “Press Button Solutions” that provides an incomplete review of various commercially available fMRI hardware and software tools.  The authors then compare these commercial solutions to spm2, a research-grade software solution, to determine how well each tool can reliably detect fMRI activations.  The author’s findings are not surprising, though one topic missing from the discussion involves regulatory issues that may restrict the ability to use more powerful research applications for clinical studies.

The Clinical Applications section is organized based on the type of indication for fMRI and includes standard clinical methodologies for pre-surgical brain mapping, as well as research-based applications and combining fMRI with other physiological tools.  Readers interested in getting a clinical fMRI program off the ground will find the chapters discussing sensorimotor and language mapping for epilepsy and tumor resections most informative and practical.  A full chapter is devoted to “Special Issues in fMRI-studies involving Children.”  The remaining chapters discuss more research-based applications, including mapping brain rehabilitation following stroke, and combining fMRI with direct cortical stimulation, transcranial magnetic stimulation, and magnetoencephalography.

This book accomplishes its goal of providing an overview of how fMRI can be applied to clinical applications.  The daunting challenges of conducting clinical fMRI studies are softened, and the reader gains focus on the various areas within their own program that they must strengthen.  While some editors may exclude valuable details that can shorten a text’s shelf-life, it is these pearls that make this title a must-have for the novice neuroimager.  While informative, this book does feed into the modern “fast and easy” philosophy and generally understates the challenges and limitations of push-button fMRI solutions that further separate the clinician from their data.  There were also a number of important issues the book did not cover, including how to properly use statistics in single subject studies, the role of functional connectivity in brain mapping, standardization of experimental paradigms, and quality control.  With these caveats in mind, I strongly recommend this book to anyone interested in learning more about the field of clinical fMRI.

It was a pleasure to review this book, which is very comprehensive in its coverage on the diagnosis, management, and prognosis of diseases of the posterior fossa. This book has described extensively and accurately the anatomical aspects of posterior fossa through skull base and intraoperative images, with apt correlation to the radiological imaging. This correlation enables the reader to understand and remember better the normal anatomy of posterior fossa.

Further, the author has covered all the important and commonly encountered topics of posterior fossa:  trauma, congenital abnormalities, vascular malformations, and tumors. There are detailed descriptions of the molecular basis of the disease, appearance on imaging, and intra-operative aspects of the disease. The images have accurate figure legends and are appropriately placed, giving a good visual description of the text. For example, the chapter “Hemagiomas and Dural Fistulas” begins with microscopic pathology, followed by imaging studies, followed by a series of illustrations describing the various approaches to the brain stem, and then finally ends with endovascular imaging and treatment. This clinico-pathological-radiological understanding is the key to accurate diagnosis and management of any disease.

In addition, I find that the topics covered are very up-to-date and relevant to the title of the book. The references are rightly chosen to include not only landmark papers on the topic but also latest developments in the management.

This book is essential to every neurosurgery resident or attending and is definitely a good study for beginners of radiology and neuroradiology who are in the process of understanding of posterior fossa anatomy and diseases. It also serves as a reference for practicing neuroradiologists for descriptions of radiological images and their appearance intraoperatively. The surgical approaches may not be of direct relevance, but the book does explain significantly the postoperative changes noted on radiological imaging.

Essentials of Pain Management by Drs. Nalini Vadivelu, Richard D. Urman, and Roberta L. Hines is a 834-page detailed text on this subject.  The authors are anesthesiologists dealing with the management of the commonest of all symptoms that practitioners deal with on a day-to-day basis.  The book is divided into nine parts covering all aspects of a pain management.  The book covers the subject broadly and chapters touch on alternative forms of treatment such as acupuncture as well as the psychosocial and psychological aspects of pain. Pharmacology of commonly used drugs is detailed. Their use is explained with diagrams, charts, and tables. These are clear and easy to follow.  Most of the chapters will be of particular interests to those in the clinical disciplines, especially in pain management practice. In this regard, the text is detailed, and the authors cover the subject comprehensively. Clear diagrams and photographs are used to show pertinent anatomical detail. These clearly demonstrate the target site/s of the various treatments. Each area of intervention is described under subheadings.  These are divided into the anatomy pertinent to the intervention and the technique.  These sections are kept short and succinct, but are in enough detail to be comprehensive. Section 6 deals with regional anesthesia techniques and is described in detail.  Surface anatomy (with photographs /diagrams) and surface anatomical landmarks relevant to the particular site are shown.  Technique and recommended pharmacologic agents are described. Further sections deal with labor pain and its management. Suggested strategies in cancer-related pain is covered.  The armamentarium of drugs, blocks, and pain pumps gives the reader a detailed overview of this subject.

Where necessary, radiographic images are provided to illustrate a particular point. A drug formulary of agents used in pain management is provided. Included is a pediatric section, which would prove valuable to those in this field.  Rehabilitation of the chronic pain sufferer is included, and the role of a multidisciplinary approach in this task is discussed.  Chapters include occupational therapy assessment and nursing perspectives in its arrangement.  Many of the chapters end with case scenarios and suggested approaches to their management. Of interest to the Neuroradiology audience would be Chapter 21 which details Principles of ultrasound techniques. This chapter gives a fairly detailed overview of ultrasound techniques in general, but especially in reference to needle guidance.  It is, of course, specifically aimed at the technique used in peripheral nerve interventions. Chapter 6 gives a very brief description of diagnostic imaging techniques used in pain management. It is very short and hence not of much value to the Neuroradiology audience.

Generally, the images and diagrams are labeled clearly and legends are suitably descriptive.  Compared to other books dealing with this subject it covers this topic broadly but in sections not as comprehensively.  Its breadth rather than its depth of detail is what impresses. References are up to date and comprehensive.  Overall an excellent book for those contemplating going into or already performing the practice of pain management.

From Neurology to Methodology and Back:  An Introduction to Clinical Neuroengineering
Natasha Maurits
Springer 2012, 285 pages, 131 Illustrations, $79.95

Stem Cells and Cancer Stem Cells:  Therapeutic Applications in Disease and Injury, Volume 2
M.A. Hayat
Springer 2012, 385 pages, 65 illustrations, $209.00

The Neurosurgical Instrument Guide
Christopher S. Eddleman
Thieme 2011, 534 pages, 240 illustrations, $64.99

Pediatric and Adolescent Concussion: Diagnosis, Management, and Outcomes
Jennifer Niskala Apps And Kevin D. Walter (Editors)
Springer 2012, 212 pages, 5 illustrations, $59.95

Phase Response Curves in Neuroscience:  Theory, Experiment, and Analysis
Series:  Springer Series in Computational Neuroscience, Vol. 6
Schultheiss, Nathan W.; Prinz, Astrid A.; Butera, Robert J. (Eds.)
Springer 2012, 518 pages, 170 illustrations, $239.00

Color Atlas of Ultrasound Anatomy
Berthold Block (author)
Thieme 2011, 328 pages, $49.99

The second edition of Differential Diagnosis in Computed Tomography, written by Drs. Burgener, Herzog, Meyers, Zaunbauer, is an 854-page hardcover text which covers the field of CT imaging. Included are six separate sections: Intracranial Lesions, Head and Neck, Spine, MSK, Thorax, Abdomen and Pelvis. Considering the parts of the book concerned with neurology (which includes a short segment on spine fractures in the MSK section), neuroradiology consumes well over half of this book (480 pages).

In the chapters on intracranial CT, the brain and extra-axial lesions, ventricles and cisterns, meninges and skull, and vascular lesions are discussed. Recognizing that, for most part, MR is the preferred imaging modality for the brain, Dr. Meyers has with some cases integrated CT and MR.  At a glance one quickly can appreciate the advantages of one over the other in different clinical settings. The same holds true when discussing spine lesions where it is clearly recognized that, besides trauma, potentially calcified lesions, and purely bony pathology, MR is vastly preferred. With the ratcheting down of imaging because of overall costs, it is worthwhile to consider the pros and cons of these modalities.

It is well recognized that the story changes when speaking of head and neck imaging:  the value of CT is unmistakably better in a number of circumstances and, most often, the only imaging needed. Nonetheless, correlative MR/CT should have been more emphasized.

The setup throughout the book is generally uniform, and the bulk of each section and chapter, aside from a couple of pages of introductory material, consists of well designed Tables which categorize and enumerate the diseases, summarize the CT findings, and comments of value concerning the disease entity itself. These tables are, of course, complimented by imaging (predominately but not exclusively CT). The neuro images are well described and appropriately labeled.

If we take the orbit chapter as an example, there would have been vast improvement in the material had the authors (Drs. Zaunbauer and Burgener) included some MR imaging and if they would have used more up-to-date, higher quality CT images. There are many advantages and important additional information gained by using MR in the orbit for ON lesions and space occupying mass. That chapter is a disappointment because, again, a reader wants to know the pluses and minuses of different imaging modalities. The authors needed, for example, to have shown the CT and MR of an optic neuritis or of optic nerve ischemia in order to demonstrate the clear-cut benefit of MR. Other examples of this could be mentioned in this review, such as in lymphomas or abscesses, and in fact in other areas of head and neck imaging.

This book is packed with information, but for the neuroradiologist the material is considered uneven—good in the brain and spine but less so in chapters in head and neck. If, in the future, the authors intend to publish a third edition of this book, they should tightly compare CT and MR. That would make for a more worthwhile publication.

In summary, this book is dated for neuroimaging. It does not address (for the most part) images with which we most commonly deal. Many other works in neuroradiology surpass this book, and therefore, anyone looking for a publication in the brain, spine, and head/neck, other purchases would be wiser.

Written by an ENT surgeon (Dr. Dunnebier) with collaboration from 2 radiologists (Drs. Beek and Pameijer), this easily portable 346-page softcover book is intended for ENT surgeons who wish to have an atlas-type demonstration of major imaging abnormalities of the head and neck. The chapters are: “Radiographic Imaging Techniques,” “Temporal Bone,” Skull Base,” “Paranasal Sinuses and Nasal Cavity,” and “The Neck.”

This is clearly intended for practicing ENT surgeons, and it succeeds in that regard. From a radiologist’s standpoint, the images and the parts worth looking at are those which show postoperative appearances. Worth noting are comments which are of interest to our surgical colleagues.

While few if any neuroradiologists would likely purchase this book, it can be a publication which could be recommended by radiologists to their head neck surgeons.

The latest issue of the Neuroimaging Clinics of North America is entitled Neuroimaging Tropical Disease, and Dr. Rakesh K. Gupta was wisely chosen as the guest editor. Dr. Gupta is widely recognized as a leading authority in neuroradiology, particularly in advanced MR techniques. He has chosen 27 authors to write chapters on 14 subjects, most of which are germane to and specifically deal with tropical disease affecting the CNS. Most of this, of course, involves infections such as TB, fungal disease, parasitic disease, and viral infections, but some chapters and the material within them, although well written, do not exclusively pertain to tropical diseases. For example, in the chapter on craniovertebral anomalies the descriptions and illustrations of the anatomy and pathological conditions shown are standard fare, and there is no reason to suspect these abnormalities are more common in the tropics. Similar comments can be made relative to the chapter on Vascular Brain Pathologies:  here we see diseases which those involved in neuroimaging often encounter. Another instance is the chapter or Hirayana Disease, which is certainly interesting, with the background of the disease and current concepts well explained along with good imaging, but again  there is little here which suggests any preference to the tropics.

Those relatively minor considerations aside, the book is very effective in providing the pathology, clinical scenarios, and imaging of diseases less frequently encountered in the Northern Hemisphere. The first chapter correlates imaging with pathology (gross and histologic) in many of these diseases such as malaria, amebiasis, neurocysticercosis, TB, pyogenic infections, Toxoplasmosis, and a number of viral encephalitides such as the Nipah virus. These are just a few that are included.

Subsequent chapters then delve more deeply into each of these subjects. The chapter which deals with just pathology of tropical disease forms a basis for the imaging which follows in subsequent chapters.  Here we read, among other entities, about tuberculosis explanations concerning the terminology/pathophysiology for granulomas, tuberculomas with solid caseation and liquefaction of caseation, and the non-granulomatous tuberculosis abscess. This chapter takes the reader through fungal infections (aspergillosis, Cryptococcosis, mucromycosis, blastomycosis, histoplasmosis), parasitic diseases, viral diseases, and nutritional deficiency states. While all entities are described and illustrated, particular emphasis is placed on the most frequent and important of the infections, such as Japaneses encephalitis, CNS tuberculosis, fungal infections, and parasitic infections. The book wanders a bit from its intended emphasis when we read the chapter on neuroimaging in postinfectious demyelination and nutritional disorders of the CNS. The material covers ADEM tumefactive demyelination, CMP/osmotic demyelination Wernicke’s, B₁₂ deficiency. These are well summarized, but again the material is not exclusive to the tropics. As an aside, Dr. Mukherji (the consulting editor) noted in his Foreword that this publication is now known as “Neuroimaging Clinics” to reflect a worldwide interest and expertise in neuroimaging. Perhaps it was a mix up in communication, but the cover of this issue still carries the title of Neuroimaging Clinics of North America.

This book is another in a long line of solid contributions to the neuroradiology literature.

For those radiologists who specialize or have a keen interest in head and neck imaging, this book, ENT—Head and Neck Surgery: Essential Procedures, may be of interest.

Basically, it describes and illustrates with crisp diagrams all of the major surgical procedures an otolaryngologist would deal with. This has significant implications for neuroradiologists, since we should know how abnormalities are approached, what the different surgical options are, what variations in anatomy affect the approach, and what complications may occur.

While only hardcore head and neck radiologist will purchase this book, it certainly is one which neuroradiologists may wish to have access to, either via their own Departmental library or via the Surgery Library in their institution.