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Disorders of the cerebellum. By Sid Gilman James R. Bloedel and Richard Lechtenberg Philadelphia F. A. Davis 1981 415 pp illustrated $40

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BOOKS
Reviews
Disorders of the Cerebellum
By Sid Gilman, James R. Bloedel, and Richard Lechtenberg
Pbilade&bia, F . A. Davis, 1981
415 pp, illustrated, $40.00
Disorders of the Cerebellum provides an extensive review of the
anatomy and physiology of the cerebellum, describes the
signs and symtoms of cerebellar disease, and reviews the
many diseases that affect this structure. For the most part this
textbook is well written and very complete. However, the
major effort appears to have been to catalog a large amount
of information rather than to synthesize a conceptual understanding.
Some may find the first section tedious and dry in its almost encyclopedic review of cerebellar anatomy. The reader
is given little general perspective for understanding the
significance or implications of the anatomy. There is an initial
attempt to do so, but it is too weak to carry the weight of the
succeeding five chapters.
The next part, based on observations of experimental animals, deals with cerebellar involvement in the regulation of
posture, tone, tremor, and movement, with an extensive discussion of muscle spindle activity and alpha motoneuron excitability. However, Chapter 9 on “Cerebellar Regulation of
Movement” is disproportionately brief. The functions of the
lateral zone are considered out of context by concentrating
on a few studies of single unit recording of neuronal activity
in the dentate nucleus. This section does not address issues
such as the anatomical relationships of the dentate nucleus
with sensory and motor cortex, which have important implications for motor regulation.
It is not until Chapter 10 that signs and symptoms of cerebellar disease in human beings are discussed. This is done
well, particularly for oculomotor disturbances. However, the
early part of the chapter suffers from failure to separate
clearly the signs and symptoms resulting from dysfunction of
the cerebellum alone from those caused by dysfunction of
adjacent structures. This may be due to heavy reliance by the
authors (Gilman and Lechtenberg) on their own observations, which are inadequately reviewed in terms of the nature
and location of the abnormal process or lesion and associated
findings such as increased intracranial pressure.
The remainder of the book deals with various specific disorders that affect the cerebellum, including degenerative, in-
468
fectious, toxic, and developmental processes, among others.
The final chapter is an evenhanded review of the uses and
complications of cerebellar stimulation in treating various diseases.
Overall, the book is clearly written, contains a wealth of
information, and is recommended. Readers not already well
acquainted with cerebellar physiology and pathophysiology
may find it difficult to get through the initial part of the book;
these readers might benefit by reading the chapters on signs
and symptoms of cerebellar disease before the rest of the
book.
Erwin B. Montgomery, Jr, M D
St. Louis, MO
Advances i n Neurology, Vol 30: Diagnosis
and Treatment of Brain Ischemia
Edited by Andrew L. Carney and Evelyn M . Anderson
New York, Raven Press, 1981
424 pp, ilhstrated, $49.50
This volume describes the clinical applications of qualitative
visualization of brain perfusion by means of transmission
computerized tomography. Bolus injection of contrast
medium permits the analysis of transient enhancement in a
single C T section, appropriate to the symptoms and clinical
problem to be investigated.
The editors of this volume have contributed directly to 9
of 27 chapters, amounting to 60% of the text. The remaining
contributions are reviews by experts in the field of cerebral
blood flow measurement, neuroanatomy, and neuroradiology, and contain no new information.
The clinical material presented attempts to validate the
ability of “functional” (electroencephalography) and noninvasive (CT scan) tests of “cerebral hemodynamics” to demonstrate-along with angiography-the
state of the cerebral
circulation. This material could have been presented in a
more concise form.
The volume reviews a broad area and contains material of
interest to neurologists, neurosurgeons, vascular surgeons,
and radiologists.
Cesare Fiescbi, M D
Universitk di Roma
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cerebellar, lechtenberg, bloedel, illustrated, disorder, richards, 415, 1981, philadelphia, gilman, sid, david, james
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