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Spinal tumors in children and adolescents
Book Reviews
mittee, headed by Robert H. Wilkins, is a prime example of the manner in which this committee has planned the presentation before asking the various contributors from North America to present their subjects. Each subject is planned in order, and the chapters are well illustrated, as each one of the authors is experienced in the field and has adequate, or more than adequate, clinical material to illustrate whatever points are to be made. The entire book is well printed and well illustrated, with an excellent up-to-date bibliography. It would be superfluous to point out the numerous outstanding examples, since anyone who is interested in this subject (and this should include all neurosurgeons) will want to own this book and will want to read various portions at intervals when specifically faced with the subject well covered in this volume. The volume begins with the study of vascular malformations, the pathology and grading, natural history of cavernous malformations, clinical presentations, and imaging. There is an excellent discussion of various diagnostic measures, blood flow studies, and operative management, and the operative techniques sections are well done. There is a good discussion of complications of surgical resection of arteriovenous malformations. One should not fail to read the excellent preface by Dr. Barrow, the editor who planned this volume, and "Clinical Decision Making in Management of Intracranial Vascular Malformations," by Eugene Flamm, M.D., from Philadelphia, who has obviously been a part of the planning process and has read the volume. He gives a conservative approach toward all modern techniques, giving each one adequate attention and expressing his own preference for the ways in which some of these lesions are treated. It would be difficult to praise this book more than the editor has already praised it in this review, but it is recommended that all neurosurgeons own this book. EBEN ALEXANDER, JR., M.D. Winston-Salem, North Carolina
Textbook of Neuropathology, Second Edition. E d i t e d by R i c h a r d L. Davis and D a v i d M. R o b e r t s o n . 1155 pages. B a l t i m o r e : W i l l i a m s & W i l k i n s , 1991. The second edition of Davis and Robertson's Textbook of Neuropathology is a comprehensive volume that generally follows the organization of the original 1985 edition. The complete spectrum of non-neoplastic diseases of the brain, spinal cord, and peripheral nerve is discussed in detail. Most chapters begin with general introductions (part pathophysiology, part editorial) that put the subsequent details about individual diseases into an overall perspective. The first four chapters on the normal histology and ultrastructure of the nervous system are particularly well done and are elegantly illustrated. The electron micrographs are superb. The chapters on congenital malformations and perinatal pathology begin with useful discussions on how to examine and/or dissect postmortem brain specimens in these categories. These are particularly designed for residents and general pathologists, but they are also useful to those neuropathologists
Surg Neurol 1991;36:71-6
73
who see relatively few pediatric cases. The normal development of the nervous system, as it applies to pediatric neuropathology, is described in some detail; this gives the reader a framework for evaluating the normality of fetuses and preterm infants. The final chapter in the book is a new one on peripheral nerve pathology. This chapter is well written, reasonably comprehensive, and could easily substitute for many of the smaller textbooks on the subject. An overall strength of the book is the extensive list of primary references at the end of each chapter. By necessity, the references include many older, "classic" citations, but more recent articles are included as appropriate. The only general deficiency noted was the uneven quality of the photographs of gross specimens. While some were of high quality, others detracted from the text. In summary, this text organizes an enormous amount of detail into a volume that is relatively easy to ready. It can be recommended with confidence to a wide audience, including residents and attending physicians in pathology, neurology, and neurosurgery. BARBARA J. CRAIN, M.D., Ph.D. Durham, North Carolina
S p i n a l T u m o r s in C h i l d r e n a n d A d o l e s c e n t s . E d i t e d by Ignacio P a s c u a l - C a s t r o v i e j o . 296 pages. $108.00. Raven: N e w Y o r k . It will surprise some potential readers that a volume on spinal tumors would be largely produced by a neurologist rather than a neurosurgeon. Nevertheless, the e d i t o r - - a n d author of three quarters of the chapters of this b o o k - - i s an eminent pediatric neurologist in Madrid, who clearly has extensive experience with children so afflicted and has produced a lively and useful volume on this subject. Pascual-Castroviejo has written chapters about specific tumors arising from gila, meninges and roots, neural crest, cartilage, bone and soft tissues, as well as vascular lesions, inflammatory lesions, and congenital malformations. Chapters by other contributors discuss the radiation therapy of spinal tumors, neuroimaging, and neuropathology. Except for one major chapter by Dr. Fred Epstein on the subject of intramedullary spinal cord tumors, there is virtually no discussion of surgical technique in the book. Important issues, such as the question of spinal stability in growing children after tumor resection, are never considered. The book would be improved if it were seasoned with other chapters with practical operative advice. An interesting issue that comes up in discussion of pediatric spinal tumors is the relationship between neoplastic disease and congenital anomalies. The discussion of the epidemiology of spinal cord tumors in children in the first chapter makes it clear that this is a problem in comparing various series. While it may be reasonable to discuss these non-neoplastic conditions in this book, many neurosurgeons will probably dispute some of the conclusions about timing of treatment of spinal lipomas and approaches to the treatment of syringomyelia, for example. In general, the author has very short discussions about these
74
Surg Neurol 1991;36:71-6
issues, and the recommendations are stated somewhat tentatively. These topics represent areas where the book is wandering a bit off its course and will probably not significantly diminish the value of this book for the neurosurgeon. This book succeeds best as a source of information on rare spinal tumors and spinal manifestations of more common pediatric tumors, such as neuroblastoma. The emphasis is clinical and practical. The radiological images are well reproduced and up to date. Overall, it is a pleasure to read a book written by an experienced clinician without a particular surgical ax to grind. This volume will fill a useful niche on the shelves of neurosurgical services that occasionally see these unusual tumors. JOSEPH R. MADSEN, M.D. Boston, Massachusetts
M R I o f t h e B r a i n II: N o n - n e o p l a s t i c D i s e a s e . The Raven MRI Teaching File. E d i t e d by M i c h a e l B r a n d t - Z a w a d z k i and W i l l i a m G. B r a d l e y , Jr. 224 pages. $60.00. N e w Y o r k : Raven, 1990.
The Raven MRI Teaching File is a series of 10 books, each containing 100 cases and discussions. The series comprises eight organ-specific volumes, including three devoted to the brain and one each to the spine, head and neck, musculoskeletal system, body, and cardiovascular system. Also included are two general volumes covering pediatric MRI and principles and artifacts of MRI. All volumes are edited by acknowledged leaders and experts in magnetic resonance applications in their given field. The three volumes dedicated to MRI of the brain have differing focuses, although some content is necessarily shared. Volume I emphasizes the non-neoplastic entities of flow phenomena, vascular abnormalities, hemorrhage, and trauma. Volume II also focuses on non-neoplastic entities: infarction, demyelinating disease, and hydrocephalus. Volume III covers neoplastic disease. As the editors state in the preface, there is considerable overlap between volumes I and II, and the volumes should be taken together for the intended thorough coverage. Our task, however, is to consider volume I1 on its own merits. The stated purpose of the entire Raven MRI series is to expose the reader to a "storehouse of experience" to aid in the development of proficiency in MRI. Emphasis is placed upon demonstrating the variable presentation of common pathological conditions. Case presentations use the teaching file approach: images and a brief history appear on the left page, and a description of the findings, the diagnosis, a brief discussion, and a short list of references follow on the facing page. Of the 100 cases in volume II, approximately two thirds deal with the stated emphasis on infarction, demyelination, or hydrocephalus. By far the largest number of cases pertain to various manifestations of infarction and of multiple sclerosis. Owing to the large variety of examples, coverage of these diseases is quite thorough and up to date. Ten other causes or manifestations of demyelination or dysmyelination are touched upon, giving a broad yet palatable overview of the spectrum of unusual and
Book Reviews
complex disorders that can be daunting when presented in the more usual encyclopedic text format. Quite a few cases deal with CNS infection (not a stated emphasis), especially the fungal and viral forms. There is also a curious preponderance of examples of cysticercosis (four cases). A good overview of CNS manifestations of AIDS is presented over the course of the volume. The remaining cases cover a wide array of conditions from gray matter heterotopia to CNS sarcoidosis to normal imaging variants, such as dilated perivascular spaces. Multiple images are presented for every case, and the majority of these meet current-day standards of quality. Some of the images illustrating unusual cases are presented at less than optimal window and level, presumably because of the limited availability of examples from which to choose. CT scans are included when illustrative. The description of findings is generally quite thorough, and it is here that many of the "tricks of analysis" that come from the authors' extensive experience are purveyed. The diagnoses are listed plainly for emphasis. The discussions, brief and informative, usually include a differential diagnosis and a discussion of the major teaching points of the case in question. New points are brought out in subsequent cases, so that thorough coverage of complicated topics is achieved, overlong discussions are avoided, and the reader's attention is effectively maintained. References for each case are drawn from the clinical as well as the imaging literature. There is a very detailed index. Drawbacks include the relative infrequency of gadolinium-enhanced images, inconsistencies in the writing styles of contributing authors, and, as previously mentioned, the occasional poor image. MRI of the Brain II: Non-neoplastic Disease is a well-constructed collection of teaching cases that achieves its stated goal of exposing the reader to the ins and outs of common processes, as well as enough unusual cases to represent a year or two of experience. This volume, and by extrapolation perhaps all three volumes dealing with MRI of the brain, would be especially useful to those without extensive training in MRI who desire to broaden their experience rapidly. Because the teaching file approach does not lend itself to reference or repeated use, this series may be most cost effective where it could be used by numerous individuals, such as the library of a teaching institution or group practice. Certainly no more current, state-of-the-art case collection is available today. MARK E. C. S H O G R Y , M.D. Winston-Salem, North Carolina
Langman's Medical Embryology, 6th Edition. By T. W. Sadler, $28.95. 4 0 0 pages. B a l t i m o r e : W i l liams and W i l k i n s , 1990. The objective of this text, as stated in the original preface, is to provide a concise overview of human development for medical students. It is intended that this overview of development be presented without an overwhelming wealth of detail, so that students may begin to assemble for themselves a coherent mental outline of human embryology. In addition to providing this overview of development, the book includes considerable
mittee, headed by Robert H. Wilkins, is a prime example of the manner in which this committee has planned the presentation before asking the various contributors from North America to present their subjects. Each subject is planned in order, and the chapters are well illustrated, as each one of the authors is experienced in the field and has adequate, or more than adequate, clinical material to illustrate whatever points are to be made. The entire book is well printed and well illustrated, with an excellent up-to-date bibliography. It would be superfluous to point out the numerous outstanding examples, since anyone who is interested in this subject (and this should include all neurosurgeons) will want to own this book and will want to read various portions at intervals when specifically faced with the subject well covered in this volume. The volume begins with the study of vascular malformations, the pathology and grading, natural history of cavernous malformations, clinical presentations, and imaging. There is an excellent discussion of various diagnostic measures, blood flow studies, and operative management, and the operative techniques sections are well done. There is a good discussion of complications of surgical resection of arteriovenous malformations. One should not fail to read the excellent preface by Dr. Barrow, the editor who planned this volume, and "Clinical Decision Making in Management of Intracranial Vascular Malformations," by Eugene Flamm, M.D., from Philadelphia, who has obviously been a part of the planning process and has read the volume. He gives a conservative approach toward all modern techniques, giving each one adequate attention and expressing his own preference for the ways in which some of these lesions are treated. It would be difficult to praise this book more than the editor has already praised it in this review, but it is recommended that all neurosurgeons own this book. EBEN ALEXANDER, JR., M.D. Winston-Salem, North Carolina
Textbook of Neuropathology, Second Edition. E d i t e d by R i c h a r d L. Davis and D a v i d M. R o b e r t s o n . 1155 pages. B a l t i m o r e : W i l l i a m s & W i l k i n s , 1991. The second edition of Davis and Robertson's Textbook of Neuropathology is a comprehensive volume that generally follows the organization of the original 1985 edition. The complete spectrum of non-neoplastic diseases of the brain, spinal cord, and peripheral nerve is discussed in detail. Most chapters begin with general introductions (part pathophysiology, part editorial) that put the subsequent details about individual diseases into an overall perspective. The first four chapters on the normal histology and ultrastructure of the nervous system are particularly well done and are elegantly illustrated. The electron micrographs are superb. The chapters on congenital malformations and perinatal pathology begin with useful discussions on how to examine and/or dissect postmortem brain specimens in these categories. These are particularly designed for residents and general pathologists, but they are also useful to those neuropathologists
Surg Neurol 1991;36:71-6
73
who see relatively few pediatric cases. The normal development of the nervous system, as it applies to pediatric neuropathology, is described in some detail; this gives the reader a framework for evaluating the normality of fetuses and preterm infants. The final chapter in the book is a new one on peripheral nerve pathology. This chapter is well written, reasonably comprehensive, and could easily substitute for many of the smaller textbooks on the subject. An overall strength of the book is the extensive list of primary references at the end of each chapter. By necessity, the references include many older, "classic" citations, but more recent articles are included as appropriate. The only general deficiency noted was the uneven quality of the photographs of gross specimens. While some were of high quality, others detracted from the text. In summary, this text organizes an enormous amount of detail into a volume that is relatively easy to ready. It can be recommended with confidence to a wide audience, including residents and attending physicians in pathology, neurology, and neurosurgery. BARBARA J. CRAIN, M.D., Ph.D. Durham, North Carolina
S p i n a l T u m o r s in C h i l d r e n a n d A d o l e s c e n t s . E d i t e d by Ignacio P a s c u a l - C a s t r o v i e j o . 296 pages. $108.00. Raven: N e w Y o r k . It will surprise some potential readers that a volume on spinal tumors would be largely produced by a neurologist rather than a neurosurgeon. Nevertheless, the e d i t o r - - a n d author of three quarters of the chapters of this b o o k - - i s an eminent pediatric neurologist in Madrid, who clearly has extensive experience with children so afflicted and has produced a lively and useful volume on this subject. Pascual-Castroviejo has written chapters about specific tumors arising from gila, meninges and roots, neural crest, cartilage, bone and soft tissues, as well as vascular lesions, inflammatory lesions, and congenital malformations. Chapters by other contributors discuss the radiation therapy of spinal tumors, neuroimaging, and neuropathology. Except for one major chapter by Dr. Fred Epstein on the subject of intramedullary spinal cord tumors, there is virtually no discussion of surgical technique in the book. Important issues, such as the question of spinal stability in growing children after tumor resection, are never considered. The book would be improved if it were seasoned with other chapters with practical operative advice. An interesting issue that comes up in discussion of pediatric spinal tumors is the relationship between neoplastic disease and congenital anomalies. The discussion of the epidemiology of spinal cord tumors in children in the first chapter makes it clear that this is a problem in comparing various series. While it may be reasonable to discuss these non-neoplastic conditions in this book, many neurosurgeons will probably dispute some of the conclusions about timing of treatment of spinal lipomas and approaches to the treatment of syringomyelia, for example. In general, the author has very short discussions about these
74
Surg Neurol 1991;36:71-6
issues, and the recommendations are stated somewhat tentatively. These topics represent areas where the book is wandering a bit off its course and will probably not significantly diminish the value of this book for the neurosurgeon. This book succeeds best as a source of information on rare spinal tumors and spinal manifestations of more common pediatric tumors, such as neuroblastoma. The emphasis is clinical and practical. The radiological images are well reproduced and up to date. Overall, it is a pleasure to read a book written by an experienced clinician without a particular surgical ax to grind. This volume will fill a useful niche on the shelves of neurosurgical services that occasionally see these unusual tumors. JOSEPH R. MADSEN, M.D. Boston, Massachusetts
M R I o f t h e B r a i n II: N o n - n e o p l a s t i c D i s e a s e . The Raven MRI Teaching File. E d i t e d by M i c h a e l B r a n d t - Z a w a d z k i and W i l l i a m G. B r a d l e y , Jr. 224 pages. $60.00. N e w Y o r k : Raven, 1990.
The Raven MRI Teaching File is a series of 10 books, each containing 100 cases and discussions. The series comprises eight organ-specific volumes, including three devoted to the brain and one each to the spine, head and neck, musculoskeletal system, body, and cardiovascular system. Also included are two general volumes covering pediatric MRI and principles and artifacts of MRI. All volumes are edited by acknowledged leaders and experts in magnetic resonance applications in their given field. The three volumes dedicated to MRI of the brain have differing focuses, although some content is necessarily shared. Volume I emphasizes the non-neoplastic entities of flow phenomena, vascular abnormalities, hemorrhage, and trauma. Volume II also focuses on non-neoplastic entities: infarction, demyelinating disease, and hydrocephalus. Volume III covers neoplastic disease. As the editors state in the preface, there is considerable overlap between volumes I and II, and the volumes should be taken together for the intended thorough coverage. Our task, however, is to consider volume I1 on its own merits. The stated purpose of the entire Raven MRI series is to expose the reader to a "storehouse of experience" to aid in the development of proficiency in MRI. Emphasis is placed upon demonstrating the variable presentation of common pathological conditions. Case presentations use the teaching file approach: images and a brief history appear on the left page, and a description of the findings, the diagnosis, a brief discussion, and a short list of references follow on the facing page. Of the 100 cases in volume II, approximately two thirds deal with the stated emphasis on infarction, demyelination, or hydrocephalus. By far the largest number of cases pertain to various manifestations of infarction and of multiple sclerosis. Owing to the large variety of examples, coverage of these diseases is quite thorough and up to date. Ten other causes or manifestations of demyelination or dysmyelination are touched upon, giving a broad yet palatable overview of the spectrum of unusual and
Book Reviews
complex disorders that can be daunting when presented in the more usual encyclopedic text format. Quite a few cases deal with CNS infection (not a stated emphasis), especially the fungal and viral forms. There is also a curious preponderance of examples of cysticercosis (four cases). A good overview of CNS manifestations of AIDS is presented over the course of the volume. The remaining cases cover a wide array of conditions from gray matter heterotopia to CNS sarcoidosis to normal imaging variants, such as dilated perivascular spaces. Multiple images are presented for every case, and the majority of these meet current-day standards of quality. Some of the images illustrating unusual cases are presented at less than optimal window and level, presumably because of the limited availability of examples from which to choose. CT scans are included when illustrative. The description of findings is generally quite thorough, and it is here that many of the "tricks of analysis" that come from the authors' extensive experience are purveyed. The diagnoses are listed plainly for emphasis. The discussions, brief and informative, usually include a differential diagnosis and a discussion of the major teaching points of the case in question. New points are brought out in subsequent cases, so that thorough coverage of complicated topics is achieved, overlong discussions are avoided, and the reader's attention is effectively maintained. References for each case are drawn from the clinical as well as the imaging literature. There is a very detailed index. Drawbacks include the relative infrequency of gadolinium-enhanced images, inconsistencies in the writing styles of contributing authors, and, as previously mentioned, the occasional poor image. MRI of the Brain II: Non-neoplastic Disease is a well-constructed collection of teaching cases that achieves its stated goal of exposing the reader to the ins and outs of common processes, as well as enough unusual cases to represent a year or two of experience. This volume, and by extrapolation perhaps all three volumes dealing with MRI of the brain, would be especially useful to those without extensive training in MRI who desire to broaden their experience rapidly. Because the teaching file approach does not lend itself to reference or repeated use, this series may be most cost effective where it could be used by numerous individuals, such as the library of a teaching institution or group practice. Certainly no more current, state-of-the-art case collection is available today. MARK E. C. S H O G R Y , M.D. Winston-Salem, North Carolina
Langman's Medical Embryology, 6th Edition. By T. W. Sadler, $28.95. 4 0 0 pages. B a l t i m o r e : W i l liams and W i l k i n s , 1990. The objective of this text, as stated in the original preface, is to provide a concise overview of human development for medical students. It is intended that this overview of development be presented without an overwhelming wealth of detail, so that students may begin to assemble for themselves a coherent mental outline of human embryology. In addition to providing this overview of development, the book includes considerable