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Cerebral vascular disease 5. Edited by J. S. Meyer H. Lechner M. Reivich and E. O. Ott Amsterdam Elsevier Biomedical Press BV 1985 377 pp illustrated $74

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Stroke Rehabilitation
By Paul E. Kaplan and Leonard J . Cerullo
Boston, Butterworth Publishws, 1986
421 pp, illustrated, $39.95
Of the 18 chapters in this volume, 7 are devoted to a combination of functional anatomy-physiology and considerations
about acute stroke, including diagnosis, medical management, and indications for endarterectomy. The actual chapters OR rehabilitation vary from the abstract to the quite
specific, perhaps because the effects of rehabilitation versus
general good medical care and encouragement are so difficult
to quantify. Most physicians reading this book will regret
that it has not been more focused and to the point in terms
of recommendations for what to do, when, and to whom. An
exception is Chapter 12 on Nursing Therapy; Geibel and
Kubalanza-Sipp’s dissertation is ideal in its declarative, didactic, and practical approach. Would that all books on rehabilitation and, indeed, many dealing with other aspects of
practical neurology, incorporate these principles.
Molecular Mechanisms of Ischemic Brain Damage
(Vol63, Progress in Brain Research)
Edited b.r K. Kogure, K.-A. Hossmnn, B. K. Siesjo,
and F . A. Welsch
Amrterdam, Elsevier Biomedical Press BV, 1986
264 pp, illustrated, $79.95
This well-produced monograph joins a distinguished series
to discuss various aspects of experimental work on the subject of ischemic brain damage. Major sections include Selective Neuronal Vulnerability, Cellular Calcium and Hydrogen
Ion Homeostasis, and Alterations in Protein and Lipid Metabolism. The chapters are reasonably long and detailed, with
excellent bibliographies. The volume appeared within a relatively short time after the initial meeting in Sendai in 1984.
The excellent quality of the illustrations and the detail of the
material make the book well worth having for anyone working directly in this field of experimental stroke research.
Surgery of Occlusive Cerebrovascular Disease
By R. S. A. Lord
St. Louis, C. V . Mosby, 1986
543 pp, illustrated, $84.95
Together with his publisher, Dr Lord, Professor of Surgery
at the University of New South Wales, Australia, presents a
beautifully prepared, scholarly, comprehensively referenced,
and detailed book on cerebrovascular disease, written with
the special bias of the vascular surgeon. The first 226 pages
provide excellent summaries of the clinical pathophysiology,
mechanisms, syndromes, and diagnostic aspects of stroke.
The last 286 pages effectively describe the vascular surgical
options available for intervening in almost any form of arterial anomaly, including, among others, asymptomatic cervical
artery stenosis, kinking or coiling of cervical arteries, completed stroke, fibromuscular dysplasia, and vertebral artery
stenosis-occlusion. Intracranial arteriovenous malformations, aneurysms, and hemorrhages are omitted from the
discussion, presumably as being the proper province of the
neurosurgeon. Lord fairly and comprehensively discusses potential complications, varying indications, technical considerations, and the like, and includes such published material as
Berguer’s (in press) observation that computed tomographic
examinations show as many as 6% perioperative asymptomatic strokes after endarterectomy. Nevertheless, undaunted,
Lord does not incorporate the caution implied by these kinds
of data into an attitude that would pose the question demanded in any volume on treatment: What scientifically
gathered evidence establishes this form of therapy as superior to others in any form of cerebrovascular disease?
Illustrating this attitude, Lord dismisses interinstitutional
comparisons of surgical outcomes as “unproductive.” Similarly, despite citing the results of the extracranial-intracranial
bypass studies and noting data that indicate the procedure
has no favorable influence on morbidity or late mortality, a
lengthy chapter proceeds to describe the available surgical
procedures and serially provides references to “good” surgical results. Nowhere can one find comprehensive critical
tabular data comparing outcome from any of the recommended surgical treatments with outcomes from other
therapies-most information of this nature coming from a
group of practitioners selected because of their background
in vascular surgery. Neurologists have found it particularly
difficult to get preoperative or postoperative appraisals
among this group of patients. Surely the time has come when
neurologists and physicians should demand more of surgeons
than optimistic retrospectroscopics in the recommendation
of treatment for cerebrovascular disease. At the least, results
should be prospectively evaluated by medical-surgical teams
and those results subjected to late follow-up. Even then,
doubts will remain until or unless surgeons accept the fact
that the results of their craft require the same controlled
scientific appraisal as medicine has required in the evaluation
of new drugs.
Cerebral Vascular Disease 5
Edited by J . S. Mow, H.Lechnw, M . Reivich, and E. 0. Ott
Amsterdam, Elsevier Biomedical Press BV, I985
377 pp, illustrated, $74.00
This text contains the proceedings of the 12th Salzburg Conference held in September of 1984. The volume, which concentrates mainly on clinical and clinically related studies,
covers Technical Diagnosis, Imaging Techniques, Hemorrheology, Stroke in the Young, various aspects of cerebral
infarction, and a section on special contributions, especially
pharmacological. The use of photo offset printing permitted
a reasonably short publication time. Although the quality of
the discussions is emphasized in John Marshall’s introduction, these discussions are not included in the final text.
Migraine: Clinical and Research Advances
Edited by F. Clifford Rose
London, k r g w , I984
2 79 pp, illustrated, $74.5 0
The volume represents the proceedings of a biennial meeting
sponsored by the Migraine Trust and held in London in
Annals of Neurology
Vol 22 N o 2
August 1987 287
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ott, vascular, illustrated, disease, lechner, meyer, biomedical, reivich, cerebral, amsterdam, edited, 377, elsevier, pres, 1985
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