BOOKS

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 symp- tom 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 exam- ple, 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 de- spite 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 illus- trations, 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 refer- ences are new to this edition. Historical references are re- placed by more recent practical treatises in keeping with the author’s purpose.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 practi- cal 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 grow- ing 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, ye t there is a paucity of books related to this important anatomical region. This multiauthored book, with predominantly Euro- pean authors and edited by an outstanding neuroradiologist, is a welcome, as well as an important, addition to the liter- ature.

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 de- generative diseases particularly merit reading; they are com- prehensive and offer excellent anatomical/pathological/clin- ical 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, MD

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 coau- thors-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 microvas- cular 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 de- oxyglucose autoradiographs and angiograms to illustrate sa- lient points. Subsequent chapters review the biology of endo- thelium 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 excit- atory neurotransmitter in the brain and one increasingly im- plicated in mechanisms of tissue injury. (The rapid pace o! evolution of this field is epitomized by the rather scant atten- tion devoted to nitric oxide, a neuromodulator increasingly implicated in both normal circulatory control and in patho- physiological responses of vessels and parenchyma.) Func- tional circuitry and activation are covered at two separate points of the volume, and the contributions of the deoxyglu- cose 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 hemor- rhage, and aging.

Although one can take issue with the relative emphasis accorded the various topics, these objections are far out- weighed by the overall impact and usefulness of this volume,

Copyright 0 1993 by the American Neurological Association 117