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Management of Cerebral Aneurysms
Book Reviews
Management of Cerebral Aneurysms Peter D. Le Roux, H. Richard Winn, David Newell, eds. Philadelphia: Saunders, 2004 ISBN 0-7216-8754-7; 704 pp, 329 illus; $149.00 Rating: 多多多 Recommended Audience: Neurosurgeons, neurosurgery residents, neurologists, neuroradiologists
This text is edited by three well-known experts in the field of aneurysm neurosurgery and contains chapter contributions from many other highly experienced and internationally respected neurosurgeons and interventional neuroradiologists whose names are familiar to students of clinical management of intracranial aneurysms. It is subdivided into three parts: 1) background, 2) evaluation and perioperative care, and 3) surgical techniques of aneurysm occlusion. The background part is especially strong with excellent reviews of the history of aneurysm treatment, cerebrovascular anatomy, aneurysm biology, flow dynamics, epidemiology, rupture biophysics, and clinical pathobiology of subarachnoid hemorrhage. The second and third parts present good summaries of the current state of perioperative care and surgical treatment of aneurysms as well as introductions to the neurointerventional radiological treatments for aneurysms. The written material is supplemented with diagrams, drawings, and both black-and-white and color photos. There also are many good intraoperative and autopsy-material photomicrographs which depict operative approaches and exposures. Additionally, the text contains many photographs of angiograms and other imaging studies which illustrate commonly-encountered lesions. Although the text suffers somewhat from the redundancy typical of this type of multiauthored approach, several of the chapters deserve special mention. Dr. Douglas Chyatte has presented the best discussion I have seen of aneurysm pathology in a general text. He reviews commonly-accepted concepts and then presents a balanced discussion of more speculative ideas that have arisen primarily from his extensive laboratory experience in immunologic and genetic approaches to aneurysm pathobiology. I suspect we will see many of these ideas gain more acceptance in the © 2004 Elsevier Inc. All rights reserved. 360 Park Avenue South, New York, NY 10010 –1710
future as his work and the work of others in the cell biology of aneurysm pathology progresses. Drs. Wakhloo, Lieber, Sandhu, and Gounis have contributed as rigorous a discussion of the flow dynamics in aneurysms as is possible for a clinical audience. They have presented a readable summary of the basic concepts of the physics of cerebrovascular flow and have applied these concepts to commonly-encountered aneurysm geometries. They have also provided an introduction to mathematical modeling of flow and have shown how this modeling may become more relevant to clinical practice, especially as intravascular therapies evolve. Drs. Alterman and Oishi have presented an excellent discussion of the rationale for screening for aneurysms in some populations and Dr. Joseph King has contributed an excellent discussion of practical considerations regarding cost and quality of life in aneurysm patients. Finally, Dr. John Frazee has added a succinct discussion of the potential of stereotaxis and endoscopy to make the surgical treatment of aneursyms less invasive. While there are many excellent contributions in the text by these and other authors regarding basic science, perioperative management, and surgical treatment, the only drawback in the book is that it does not provide as much attention to interventional neuroradiological treatment as some might desire. While the book will serve as a valuable resource both to beginning students and experienced practitioners of surgery, those seeking detailed information regarding techniques of intravascular therapy will likely need to seek additional sources of information. In summary, this is an excellent text regarding the management of intracranial aneurysms. It is refreshingly forward-looking with respect especially to advancements in basic science which will likely alter the future of treatment. This book will be a valuable addition to the libraries of those who treat patients with intracranial aneurysms. Phillip Dickey, M.D. New Haven, Connecticut doi:10.1016/j.surneu.2004.07.037 0090-3019/04/$–see front matter
Management of Cerebral Aneurysms Peter D. Le Roux, H. Richard Winn, David Newell, eds. Philadelphia: Saunders, 2004 ISBN 0-7216-8754-7; 704 pp, 329 illus; $149.00 Rating: 多多多 Recommended Audience: Neurosurgeons, neurosurgery residents, neurologists, neuroradiologists
This text is edited by three well-known experts in the field of aneurysm neurosurgery and contains chapter contributions from many other highly experienced and internationally respected neurosurgeons and interventional neuroradiologists whose names are familiar to students of clinical management of intracranial aneurysms. It is subdivided into three parts: 1) background, 2) evaluation and perioperative care, and 3) surgical techniques of aneurysm occlusion. The background part is especially strong with excellent reviews of the history of aneurysm treatment, cerebrovascular anatomy, aneurysm biology, flow dynamics, epidemiology, rupture biophysics, and clinical pathobiology of subarachnoid hemorrhage. The second and third parts present good summaries of the current state of perioperative care and surgical treatment of aneurysms as well as introductions to the neurointerventional radiological treatments for aneurysms. The written material is supplemented with diagrams, drawings, and both black-and-white and color photos. There also are many good intraoperative and autopsy-material photomicrographs which depict operative approaches and exposures. Additionally, the text contains many photographs of angiograms and other imaging studies which illustrate commonly-encountered lesions. Although the text suffers somewhat from the redundancy typical of this type of multiauthored approach, several of the chapters deserve special mention. Dr. Douglas Chyatte has presented the best discussion I have seen of aneurysm pathology in a general text. He reviews commonly-accepted concepts and then presents a balanced discussion of more speculative ideas that have arisen primarily from his extensive laboratory experience in immunologic and genetic approaches to aneurysm pathobiology. I suspect we will see many of these ideas gain more acceptance in the © 2004 Elsevier Inc. All rights reserved. 360 Park Avenue South, New York, NY 10010 –1710
future as his work and the work of others in the cell biology of aneurysm pathology progresses. Drs. Wakhloo, Lieber, Sandhu, and Gounis have contributed as rigorous a discussion of the flow dynamics in aneurysms as is possible for a clinical audience. They have presented a readable summary of the basic concepts of the physics of cerebrovascular flow and have applied these concepts to commonly-encountered aneurysm geometries. They have also provided an introduction to mathematical modeling of flow and have shown how this modeling may become more relevant to clinical practice, especially as intravascular therapies evolve. Drs. Alterman and Oishi have presented an excellent discussion of the rationale for screening for aneurysms in some populations and Dr. Joseph King has contributed an excellent discussion of practical considerations regarding cost and quality of life in aneurysm patients. Finally, Dr. John Frazee has added a succinct discussion of the potential of stereotaxis and endoscopy to make the surgical treatment of aneursyms less invasive. While there are many excellent contributions in the text by these and other authors regarding basic science, perioperative management, and surgical treatment, the only drawback in the book is that it does not provide as much attention to interventional neuroradiological treatment as some might desire. While the book will serve as a valuable resource both to beginning students and experienced practitioners of surgery, those seeking detailed information regarding techniques of intravascular therapy will likely need to seek additional sources of information. In summary, this is an excellent text regarding the management of intracranial aneurysms. It is refreshingly forward-looking with respect especially to advancements in basic science which will likely alter the future of treatment. This book will be a valuable addition to the libraries of those who treat patients with intracranial aneurysms. Phillip Dickey, M.D. New Haven, Connecticut doi:10.1016/j.surneu.2004.07.037 0090-3019/04/$–see front matter