Advances in Stroke Therapy Edited by F . Cli#ord Rose New York. Rawn Press, 1982 405 pp. illustrated, $62.50

This book represents the proceedings of the Mansell Bequest Symposium, which was sponsored by the Medical Society of London. I t is intended to “provide a survey of the most re- cent progress in the understanding, management and preven- tion of stroke and in the rehabilitation of stroke patients.” In this multiauthored compendium, initial papers deal with the basic aspects of stroke, and later sections are concerned with the treatment of acute stroke, stroke prevention, surgical as- pects of stroke, remedial therapy, therapeutic trials, stroke units, and stroke in the community.

Unfortunately, many of the chapters are short, and some likely represent no more than the abstracts of the papers presented. A few of the contributions describe original re- search, while others are short reviews of potentially contro- versial areas. The quality of the reports and the value of the information contained in them are quite variable. Some sec- tions, however, such as those on stroke epidemiology, are concise and well done. Other sections, such as those on stroke units and rehabilitation, present little convincing data and mainly contain a plea to justify the existence of these units.

The book’s greatest interest lies in the opportunity it offers to compare modes of stroke therapy in the United States with those currently employed in the United Kingdom and Europe. For example, despite the increasing frequency of the performance of carotid endarterectomy in the United States, the procedure is relatively uncommon in the United Kng- dom. This observation has important implications for current modes of stroke prevention and for systems of medical care delivery in both countries.

The editor has intended this volume to be of interest to all physicians involved in the management of stroke, but its brevity limits its usefulness as a resource for workers in the field.

Robert A. Kati-heson. M D Clei’eland. OH

Controversies in Neurology Edited by R. A. Thompson and J . R. Green New York. Rawn Press, 108s I90 pp. iffu.rtrutrd, $42.50

This monograph proposes to give a brief overview of the current approaches to the management of a variety of contro- versial conditions of neurological and neurosurgical impor- tance. The subjects covered include cervical disc disease and cervical spondylosis, spinal epidural rnetascases, the manage- ment of malignant brain tumors, cerebrovascular disease, ar- teriovenous malformations, and aneurysms. For the most part, the various authors have been admirably successful. The discussions are generally clear, logical, and succinct, yet con- tain an adequate list of references.

Of special interest is the excellent discussion of the medical and surgical management of extracranial vascular occlusive disease. The chapters entitled “Asymptomatic Carotid Bruit” and “Cerebral Vascular Disease: Antiplatelet and Anticoagu-

lant Treatment” are excellently written and together point to the continuing difficulty in defining the risk-benefit ratio of treatments for this common disease.

Two chapters in this monograph are not successful in pre- senting an overview of the problems discussed. The chapter entitled “Surgery, Radiation, and Chemotherapy in the Treat.- ment of Malignant Brain Tumors” discusses the approach of only one center and, while containing some excellent scientific discussion, ignores the exciting work of other inves- tigators in this expanding field. The chapter on the manage- ment of arteriovenous malformations is superficial and does not contain a worthwhile bibliography.

For the most part, this monograph successfully presents the controversial aspects of several problems in neurology and neurosurgery. Its succinct nature makes it a worthwhile addition to the libraries of neurologists, neurosurgeons, and orthopedists.

Harold L. Rekate, M D Cleveland, OH

Neurology of Hereditary Metabolic Diseases of Children By Raymond D. Adam and Gilles Lyon New York. McGruw-Hill Book Compaq ~ 1982 45 6 p p , illustrated, $49.5 0

Neurologists have usually considered the differential diag- nosis of lipidoses and leukodystrophics within a develop- mental frame of reference. The authors have used a similar approach to discuss diseases that are heritable, progressive, neurological in their major expression. and based on a de- monstrable biochemical abnormality. The authors exclude heritable metabolic diseases that have no clear neurological representation as well as those whose genetic basis and medh- anisms are clearly nonprogressive, such as chromosomal ab- normalities.

The principal guidelines of discussion are the natural teni- poral course of the disease and age at onset of symptoms. Age groups include the neonatal period, early infancy ( 1 to 12 months), late infancy and early childhood (1 to 4 years), and late childhood and adolescence ( 5 to 15 years). Diseases are presented by analytical description including common clinical features and variants, diagnostic and laboratory tests, genetics, summary of pathological findings, differential diag- nosis, and treatments.

One chapter is devoted to laboratory tests that are adapt- able to office and hospital, and two additional chapters are concerned with major syndromes in relation to nonmetabolic diseases including progressive spastic paraparesis, extrapy- ramidal syndromes, ataxia, and seizures. The final chapter discusses therapy and prophylaxis.

The authors have attempted to present a systematic clinical methodology that covers each of the major groups of heredi- tary metabolic diseases of the nervous system in infancy arid childhood. They have succeeded. The book is authoritativNe, complete, and readable. This reviewer, in fact, found it difficult to put down. I t will become a standarcl text for all neurologists, as well as other clinicians involved in the care o f children with abnormalities of development.

Bruce 0. Berg. MD San Francijco, CA

216 Annals of Neurology Vol 15 N o 2 February 1984