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Clinical pediatric neurology A signs and symptoms approach ed 2. By Gerald M. Fenicbel Philadelphia W. B. Saunders 1993 416 pp illustrated $60

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Reviews
Clinical Pediatric Neurology: A Signs and Symptoms
Approach, ed 2
By Gerald M. Fenichel
Philadelphia, W. 8.Saunders, 1993
41 6 pp, illustrated, $60.00
This basic textbook is organized succinctly into eighteen
chapters that cover the most commonly encountered clinical
problems in child neurology. This type of organization has
both merits and shortcomings. The advantage offered to the
novice in child neurology is that this format allows the reader
to scan the diagnostic possibilities for a given sign or symptom complex fairly readily. Detail obviously must come from
other sources, as this text is not designed to be an exhaustive
review of each disease. The limitations of this format reside
mainly in the cataloguing of complex diseases under subject
headings that might not be entirely encompassing. For example, neurocutaneous syndromes are discussed in the chapter
dealing with psychomotor retardation and regression and
omitted from the chapter on increased intracranial pressure.
Tables are generously placed throughout the text and despite their brevity are quite comprehensive. In most cases
they have been updated to include recent clinical findings
(e.g., cocaine abuse as a cause of stroke). There are 73 illustrations, including muscle photomicrographs, fundoscopic
images, electroencephalograms, and MR scans, which add to
the clinical descriptions in the text. The reproductions of
MRIs are adequate and figure legends are informative. The
unwieldy chapter on psychomotor retardation and regression
is aided by flow diagrams for the evaluation of subtopics such
as progressive dementia. These diagrams reflect the author’s
practical style and clinical experience. One-third of the references are new to this edition. Historical references are replaced by more recent practical treatises in keeping with the
author’s purpose.
The major advantage to this book is that it has only one
author, which makes the style consistent and the text very
readable. The author’s intent of providing a manual of practical information for physicians caring for children is well met.
This book should provide the novice in child neurology with
a painless entry into a difficult, challenging, and rapidly growing field.
Donna M. Fewiero, M D
Imaging of the Spine and Spinal Cord
Edited by Claude Mane&e
New York. Raven, 1992
91 0 ppq illustrated, $ 1 70.00
Diseases related to the spine are one of the most frequent
and important aspects of most clinical practices in neurology,
orthopedics, and neuroradiology. There are a plethora of
conditions that affect the spine and the spinal cord, y e t there
is a paucity of books related to this important anatomical
region. This multiauthored book, with predominantly European authors and edited by an outstanding neuroradiologist,
is a welcome, as well as an important, addition to the literature.
The text is composed of 24 chapters that span the entire
range of spine and spinal cord problems. The book starts
with excellent neuroanatomical images that exhibit particular
attention to anatomical detail. There is a logical development
from anatomy to pathology, with complete coverage of all
pertinent spine topics. Extensive illustrations are used, and
each chapter is referenced thoroughly. The chapters on degenerative diseases particularly merit reading; they are comprehensive and offer excellent anatomical/pathological/clinical correlation.
There is a great deal of information in this book, which
could serve as a standard reference for spine imaging. The
editor is to be congratulated for producing an essential text
for all those whose medical fields relate to the spine and the
spinal cord.
Robert 1. Grossman, M D
Cerebral Blood Flow a n d Metabolism
By Lars Edz’insson, Eric T . MacKentre. and Jamrr McCulloch
New York, Ra*en, 1993
683 pp, tllustruted. $130.00
This authoritative and comprehensive volume represents a
magnificent accomplishment on the part of its three coauthors-all distinguished neuroscientists and, for decades,
close scientific collaborators. The central focus of the volume
is the cerebral circulation, yet its scope is impressively broad,
ranging from the anatomy and physiology to pharmacology
and, finally, to pathophysiology. The breadth of approach is
evident from the very first chapter, in which a discussion of
vascular anatomy proceeds from gross anatomy to microvascular organization to functional correlates of neurovascular
patterns. Superb black-and-white and color diagrams are in
abundance, and use is made of cerebral blood flow and deoxyglucose autoradiographs and angiograms to illustrate salient points. Subsequent chapters review the biology of endothelium and vascular smooth muscle-the latter is given far
more weight than the former, particularly regarding in vitro
studies. A very considerable portion of this volume (more
than 300 pages) deals with pharmacological modulation of
the cerebral circulation, with separate chapters on adrenergic
mechanisms, dopamine, serotonin, acetylcholine, histamine,
adenosine, prostanoids, neuropeptides, and amino acids.
Given this exhaustive approach, it is surprising to see so little
space devoted to glutamate itself-the predominant excitatory neurotransmitter in the brain and one increasingly implicated in mechanisms of tissue injury. (The rapid pace o!
evolution of this field is epitomized by the rather scant attention devoted to nitric oxide, a neuromodulator increasingly
implicated in both normal circulatory control and in pathophysiological responses of vessels and parenchyma.) Functional circuitry and activation are covered at two separate
points of the volume, and the contributions of the deoxyglucose autoradiographic method in analyzing local cerebral
metabolic responses are emphasized. A final portion of the
book devotes relatively brief chapters to pathophysiology,
covering disturbances of autoregulation, disordered substrate
supply, cerebral ischemia, migraine, subarachnoid hemorrhage, and aging.
Although one can take issue with the relative emphasis
accorded the various topics, these objections are far outweighed by the overall impact and usefulness of this volume,
Copyright 0 1993 by the American Neurological Association
117
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approach, illustrated, neurology, signs, 416, philadelphia, fenicbel, saunders, 1993, gerald, clinical, symptom, pediatrics
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