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Craniospinal magnetic resonance imaging. By Stephen J. Pomeranz Philadelphia Saunders 1988 677 pp illustrated $125

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Book Reviews
Brain Imaging: A n Introduction
By / o h R. Bradshaw
London, Butterworth, 1989
249 pp, illustrated, $70.00
This small book is divided into 2 major sections. Part 1 deals
with radiographic techniques relevant to brain imaging,
whereas Part 2 produces a series of cases based on certain
neurological diagnostic categories. In Part 1 there is a
significant amount of coverage (23 pages) of plain skull films
and only 8 pages of magnetic resonance imaging. The author
has also included a section on cerebral angiography, cerebral
ultrasound, computed tomography, and radionuclide brain
scanning. The discussion concerning these techniques is
short and provides the reader with only the barest essentials.
Part 2 of the book presents cases based on symptoms, such
as headache or seizures, or anatomic regions such as the
pituitary or posterior fossa. The pertinent radiographs, clinical information, and a few relevant questions are introduced,
followed by a brief discussion of the radiographic findings
and the diagnosis.
The images presented in the text are of high quality and
the authors have used arrowheads when appropriate to emphasize spec& areas of interest. Magnetic resonance images
are used too sparingly whereas there is an overabundance of
skull images. The latter are interesting from a historical perspective but are not currently performed for routine central
nervous system work-ups in most hospitals in the United
The book is well written and reads quickly. It focuses on
the important radiographic diagnoses as an introductory text
should. I believe it can be a useful primer to medical students
and residents in neurology and neurosurgery trying to
achieve a background in neuroimaging. My major reservation concerns the lack of emphasis on magnetic resonance
imaging. Nevertheless, the format of the work with clinical
history and appropriate images produces an engaging divergence for those interested in brain imaging.
Robert I. Grossman, MD
Philadelphia, P A
Craniospinal Magnetic Resonance Imaging
B y Stephen 1. Pomeranz
Philadelphia, Saunders, 1988
677 pp, illustrated, $225.00
The major emphasis of this book is on magnetic resonance
imaging (MRI) of the central nervous system. The initial
chapters deal with the physics of MRI. The introductory
physics chapters are generally well written and provide useful
information for an individual trying to learn the basic concepts of MRI. There is a very nice chapter by Spritzer and
MacFall on “Fast-Scan Imaging.” Following the introductory
chapters are specific chapters based on anatomy (i.e., sella,
cranial base) or diseases (i.e., neoplasms, trauma). The book
covers common central nemous system lesions that a medical
student, resident, or fellow should be familiar with. The
depth of the discussion is variable hut of good quality in most
cases. The referencing in some chapters is difficult to follow,
because it is neither in numeric nor alphabetical order. Indeed, in many chapters work is quoted that is not from peerreviewed journals.
The book contains an adequate quantity of good quality
illustrations. These illustrations are used judiciously to represent appropriate teaching themes. The exact location of the
radiologic finding is depicted, in many of the images, with
appropriate arrows. With these illustrations and the associated text a reader can develop an understanding of the MRI
findings in a variety of disorders affecting the central nervous
system. Each chapter is independent so that a particular topic
can be read without needing information contained in other
sections of the book. There is, however, very little discussion
on imaging algorithms for particular diagnostic situations;
rather an appendix is supplied listing the authors’ preferences. The use of enhanced MRI and the role of gradient
echo imaging is not addressed in this appendix. The text
contains no formal discussion of MRI spectroscopy.
Despite some limitations the book provides the reader
with an introduction to MRI and to the imaging characteristics of central nervous system diseases. It is geared primarily
for the practicing clinician; notwithstanding, medical students
and physicians-in-trainingwill find it a useful introduction to
MRI of the central nervous system.
Robert I. Grossman, M D
Philadelphia, PA
Missing the Meaning: A Cognitive Neuropsychological
Study of Processing of Words b y an Aphasic Patient
By David Howard and Sue Franklin
Cambridge, MA, MIT Press, 1988
171 pp, $25.UU
Many students of cognitive neuropsychology have begun to
advocate a return to the single case method. Through a stepby-step assessment of each basic cognitive process contributing to a complex skill, it is hoped that the specific processing
impairments underlying a clinical deficit can be identified.
Drs Howard and Franklin report a detailed evaluation of
single word processing in their patient MK, a 65-year-old
right-handed man who suffered a left posterior parietal infarct chat resulted in a Wernicke’s aphasia. In fact, Drs Howard and Franklin prefer to disregard the named aphasiological syndrome; instead they focus on five functional
“symptomcomplexes” that MK manifests. These include a
kind of word deafness, a deficit in auditory comprehension, a
surface dyslexia, a deep dysgraphia, and a semantic deficit in
word repetition. Through a detailed study of their patient,
the authors attempt to demonstrate that these phenomena
can be attributed to a core deficit in lexical semantic processing. The book thus can illustrate the relative value of the
single case method in characterizing intellectual impairments
when compared with the classic syndromic approach.
The book is divided into 3 sections. A brief introduction
reviews some of the previous work performed in each of the
five processing domains. A model of lexical processing is
200 Copyright 0 I990 by the American Neurological Association
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saunders, craniospinal, 677, illustrated, 125, magnetic, 1988, imagine, stephen, resonance, pomerans, philadelphia
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