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Cerebral Blood Flow: Physiologic and Clinical Aspects
Mayo Clin Proc, November 1987, Vol 62
authors have the most extensive experience in the world in this area and are obviously experts on this subject. In this material, they provide the best description available to date in the English literature relating to the surgical exposure of the distal extracranial vertebral artery. Much of this work has previously been reported in the French literature, but only condensed translations have been available in English. This section itself justifies purchase of the book. Thoralf M. Sundt, Jr., M.D. Department of Neurologic Surgery
Cerebral Blood Flow: Physiologic and Clinical Aspects, edited by James H. Wood, 792 pp, with illus, $79, New York, McGraw-Hill Book Company, 1987 Most multiauthoröd books are characterized by nonuniformity in quality, having excellent chapters written by some authors, mediocre chapters by others, and poor chapters contributed by the rest. Frequently, little cohesion is present between chapters on various related subjects, and repetition of information from one chapter to the next may be evident. In these respects, Cerebral Blood Flow, edited by James H. Wood, is atypical. Dr. Wood enlisted the help of 89 authors to write the 46 chapters in the nine sections that constitute this work. Most of the authors are wellknown authorities in the field on which they write. All the chapters are uniformly excellent, well written, and well referenced. The subjects of the chapters flow smoothly from one to another, and little redundant material is present. The chapters are adequately illustrated, and the art work is consistently good. The historical chapter by Anthony Bell is fascinating, well researched, and well written. He describes the evolution of knowledge regarding the function and circulation of the brain from its first mention in 2800 BC by the Egyptian physician Imhotep. The book is worth having for this chapter alone. The section on cerebrovascular anatomy describes in detail the arterial and venous systems of the brain in separate chapters. This section also presents the gross pathologic anatomy and light and electron microscopic features of brain
BOOK REVIEWS
1065
ischemia with clinical anatomic correlations. This information is basic enough to be useful to medical students but also of sufficient detail to be valuable to clinicians and basic scientists. Next, four chapters summarize the current information on cerebrovascular physiology and consider the mechanisms that regulate and influence cerebral blood flow: variation of perfusion pressure and metabolism, ionic and eicosanoid regulation of vascular smooth muscles, neural innervation, and blood rheology. Clinical methods for measurement of cerebral blood flow are discussed in five chapters. Detailed descriptions are provided of all the methods currently used clinically—xenon clearance, xenon inhalation, xenon-enhanced computed tomographic scanning, single photon-emission tomography, and positron-emission tomography. These clear and informative chapters should enable clinicians to understand these methods so that they may interpret contemporary clinical research reports on the subject. Experimental methods are also discussed, including the hydrogen clearance, microsphere, and autoradiographic techniques. The advantages and limitations of each of these methods are clearly presented. The section on imaging of cerebral circulation discusses ultrasonography, computed tomographic scanning, intravenous digital subtraction angiography, intra-arterial digital angiography, and conventional angiography. The advantages, methods, and pitfalls for each technique are discussed. This section should be extremely useful for clinicians who must choose which diagnostic test is most appropriate in patients who have symptoms of ischemia. Fourteen chapters on cerebrovascular pathophysiology discuss important basic science aspects of subarachnoid hemorrhage, ischemia, embolism, migraine, hypertensive encephalopathy, and arteriovenous malformations. The concepts of focal ischemic thresholds, ischemic penumbra, and cerebral steal are presented in a clear and scholarly manner. After this basic science information, the next section consists of chapters on the medical management of transient ischemia, vasospasm, and ischemic stroke. The concepts and methods described are clinically useful. The last section, "Surgical and Interventional Methods," presents "state-of-the-art" material on surgical techniques. Carotid endarterectomy and the use of intraoperative cerebral blood flow mea-
Mayo Clin Proc, November 1987, Vol 62
surements, cerebral bypass for carotid ischemia, vertebrobasilar revascularization, management of extracranial vascular disease, and transluminal angioplasty are discussed. In summary, this superb, impressive work is a classic that should be purchased by everyone interested in cerebral circulation. Its clear presentation of the basic science aspects and the clinical manifestations of vascular diseases makes it a must for neurologists and neurosurgeons, vascular surgeons, and internists as well as for basic scientists interested in the regulation of cerebral blood flow. Patrick J. Kelly, M.D. Department of Neurologic Surgery
The American Psychiatric P r e s s Textbook of Neuropsychiatry, edited by Robert E. Hales and Stuart C. Yudofsky, 490 pp, with illus, $55, Washington, DC, American Psychiatric Press, 1987 Study Guide and Self-Assessment for the American Psychiatric P r e s s Textbook of Neuropsychiatry, by Michael D. Franzen and Mark R. Lovell, 219 pp, $20, Washington, DC, American Psychiatric Press, 1987 During the past 3 decades, neurology, which has focused on the biologic basis of human behavior, and psychiatry, which has emphasized the influence of learned experiences and environmental factors on the development of human behavior, have begun to merge. This merger has resulted in the development of the field of neuropsychiatry, which also has been called behavioral neurology or organic psychiatry. The editors of The American Psychiatric Press Textbook of Neuropsychiatry have assembled a comprehensive summary of the current knowledge of this field in a clinically relevant and practical guide for students and practitioners of the neurosciences. Both the textbook and the study guide are divided into four sections. The first section covers assessment of patients and basic principles of neuropsychiatry. The pertinent neuropsychiatric aspects of the patient history, physical examination, and laboratory studies that practitioners should emphasize when evaluating a neuropsy-
BOOK REVIEWS
1066
chiatric problem are discussed. In addition, this section includes an overview of the recent research in the areas of neurotransmitters and neuroreceptors. The second and third sections review the initial signs and symptoms, general pathophysiologic features, and treatment of selected psychiatric, neurologic, and medical problems that constitute neuropsychiatric disorders. The last section discusses treatment issues in neuropsychiatry. This section provides the reader with a source of psychosocial and psychopharmacologic treatment options for patients who are suffering from neuropsychiatric disorders. Finally, the legal issues that are encountered in this patient population are outlined. The accompanying study guide and self-assessment text can be read in conjunction with the textbook to review and reinforce what one has learned about neuropsychiatry. These books are well organized, easy to read, and useful. The editors accomplish their goal of providing practitioners with an overview of the field of neuropsychiatry. If readers are looking for an extensive, in-depth coverage of the neuropathophysiologic aspects of neuropsychiatric disorders, however, other sources should be consulted. Nevertheless, this book and its accompanying study guide bridge a gap between the theoretical and the practical and provide an important source of information for anyone interested in the clinical neurosciences. Teresa A. Rummans, M.D. Department of Psychiatry and Psychology
The Somatizing Child: Diagnosis and Treatment of Conversion and Somatization Disorders (Contributions to Psychology and Medicine series), by Elsa G. Shapiro and Alvin A. Rosenfeld, 147 pp, with illus, $39, New York, Springer-Verlag, 1987 This book reviews the somatoform disorders in childhood, which consist of two subtypes—the conversion reactions and the somatization disorders. Relying on criteria from the third edition of the Diagnostic & Statistical Manual (DSMIII) (1980) of the American Psychiatric Association, Shapiro and Rosenfeld emphasize that a
authors have the most extensive experience in the world in this area and are obviously experts on this subject. In this material, they provide the best description available to date in the English literature relating to the surgical exposure of the distal extracranial vertebral artery. Much of this work has previously been reported in the French literature, but only condensed translations have been available in English. This section itself justifies purchase of the book. Thoralf M. Sundt, Jr., M.D. Department of Neurologic Surgery
Cerebral Blood Flow: Physiologic and Clinical Aspects, edited by James H. Wood, 792 pp, with illus, $79, New York, McGraw-Hill Book Company, 1987 Most multiauthoröd books are characterized by nonuniformity in quality, having excellent chapters written by some authors, mediocre chapters by others, and poor chapters contributed by the rest. Frequently, little cohesion is present between chapters on various related subjects, and repetition of information from one chapter to the next may be evident. In these respects, Cerebral Blood Flow, edited by James H. Wood, is atypical. Dr. Wood enlisted the help of 89 authors to write the 46 chapters in the nine sections that constitute this work. Most of the authors are wellknown authorities in the field on which they write. All the chapters are uniformly excellent, well written, and well referenced. The subjects of the chapters flow smoothly from one to another, and little redundant material is present. The chapters are adequately illustrated, and the art work is consistently good. The historical chapter by Anthony Bell is fascinating, well researched, and well written. He describes the evolution of knowledge regarding the function and circulation of the brain from its first mention in 2800 BC by the Egyptian physician Imhotep. The book is worth having for this chapter alone. The section on cerebrovascular anatomy describes in detail the arterial and venous systems of the brain in separate chapters. This section also presents the gross pathologic anatomy and light and electron microscopic features of brain
BOOK REVIEWS
1065
ischemia with clinical anatomic correlations. This information is basic enough to be useful to medical students but also of sufficient detail to be valuable to clinicians and basic scientists. Next, four chapters summarize the current information on cerebrovascular physiology and consider the mechanisms that regulate and influence cerebral blood flow: variation of perfusion pressure and metabolism, ionic and eicosanoid regulation of vascular smooth muscles, neural innervation, and blood rheology. Clinical methods for measurement of cerebral blood flow are discussed in five chapters. Detailed descriptions are provided of all the methods currently used clinically—xenon clearance, xenon inhalation, xenon-enhanced computed tomographic scanning, single photon-emission tomography, and positron-emission tomography. These clear and informative chapters should enable clinicians to understand these methods so that they may interpret contemporary clinical research reports on the subject. Experimental methods are also discussed, including the hydrogen clearance, microsphere, and autoradiographic techniques. The advantages and limitations of each of these methods are clearly presented. The section on imaging of cerebral circulation discusses ultrasonography, computed tomographic scanning, intravenous digital subtraction angiography, intra-arterial digital angiography, and conventional angiography. The advantages, methods, and pitfalls for each technique are discussed. This section should be extremely useful for clinicians who must choose which diagnostic test is most appropriate in patients who have symptoms of ischemia. Fourteen chapters on cerebrovascular pathophysiology discuss important basic science aspects of subarachnoid hemorrhage, ischemia, embolism, migraine, hypertensive encephalopathy, and arteriovenous malformations. The concepts of focal ischemic thresholds, ischemic penumbra, and cerebral steal are presented in a clear and scholarly manner. After this basic science information, the next section consists of chapters on the medical management of transient ischemia, vasospasm, and ischemic stroke. The concepts and methods described are clinically useful. The last section, "Surgical and Interventional Methods," presents "state-of-the-art" material on surgical techniques. Carotid endarterectomy and the use of intraoperative cerebral blood flow mea-
Mayo Clin Proc, November 1987, Vol 62
surements, cerebral bypass for carotid ischemia, vertebrobasilar revascularization, management of extracranial vascular disease, and transluminal angioplasty are discussed. In summary, this superb, impressive work is a classic that should be purchased by everyone interested in cerebral circulation. Its clear presentation of the basic science aspects and the clinical manifestations of vascular diseases makes it a must for neurologists and neurosurgeons, vascular surgeons, and internists as well as for basic scientists interested in the regulation of cerebral blood flow. Patrick J. Kelly, M.D. Department of Neurologic Surgery
The American Psychiatric P r e s s Textbook of Neuropsychiatry, edited by Robert E. Hales and Stuart C. Yudofsky, 490 pp, with illus, $55, Washington, DC, American Psychiatric Press, 1987 Study Guide and Self-Assessment for the American Psychiatric P r e s s Textbook of Neuropsychiatry, by Michael D. Franzen and Mark R. Lovell, 219 pp, $20, Washington, DC, American Psychiatric Press, 1987 During the past 3 decades, neurology, which has focused on the biologic basis of human behavior, and psychiatry, which has emphasized the influence of learned experiences and environmental factors on the development of human behavior, have begun to merge. This merger has resulted in the development of the field of neuropsychiatry, which also has been called behavioral neurology or organic psychiatry. The editors of The American Psychiatric Press Textbook of Neuropsychiatry have assembled a comprehensive summary of the current knowledge of this field in a clinically relevant and practical guide for students and practitioners of the neurosciences. Both the textbook and the study guide are divided into four sections. The first section covers assessment of patients and basic principles of neuropsychiatry. The pertinent neuropsychiatric aspects of the patient history, physical examination, and laboratory studies that practitioners should emphasize when evaluating a neuropsy-
BOOK REVIEWS
1066
chiatric problem are discussed. In addition, this section includes an overview of the recent research in the areas of neurotransmitters and neuroreceptors. The second and third sections review the initial signs and symptoms, general pathophysiologic features, and treatment of selected psychiatric, neurologic, and medical problems that constitute neuropsychiatric disorders. The last section discusses treatment issues in neuropsychiatry. This section provides the reader with a source of psychosocial and psychopharmacologic treatment options for patients who are suffering from neuropsychiatric disorders. Finally, the legal issues that are encountered in this patient population are outlined. The accompanying study guide and self-assessment text can be read in conjunction with the textbook to review and reinforce what one has learned about neuropsychiatry. These books are well organized, easy to read, and useful. The editors accomplish their goal of providing practitioners with an overview of the field of neuropsychiatry. If readers are looking for an extensive, in-depth coverage of the neuropathophysiologic aspects of neuropsychiatric disorders, however, other sources should be consulted. Nevertheless, this book and its accompanying study guide bridge a gap between the theoretical and the practical and provide an important source of information for anyone interested in the clinical neurosciences. Teresa A. Rummans, M.D. Department of Psychiatry and Psychology
The Somatizing Child: Diagnosis and Treatment of Conversion and Somatization Disorders (Contributions to Psychology and Medicine series), by Elsa G. Shapiro and Alvin A. Rosenfeld, 147 pp, with illus, $39, New York, Springer-Verlag, 1987 This book reviews the somatoform disorders in childhood, which consist of two subtypes—the conversion reactions and the somatization disorders. Relying on criteria from the third edition of the Diagnostic & Statistical Manual (DSMIII) (1980) of the American Psychiatric Association, Shapiro and Rosenfeld emphasize that a