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Neural monitoring. The prevention of intraoperative injury
Surg Neurol 1991;35:413-4
413
Book Reviews
Intraoperative Injury.
Modern Neuroradiology, Volume IV: Radiology of the Eye and Orbit.
Edited by Steven K. Salzman, Ph.D. 322 pages. $69.50 (U.S.)/$79.50 (export). Clifton, N e w Jersey: The H u m a n a Press, Inc., 1990.
Edited by Thomas H. Newton, M.D., and Lorissa T. Bilaniuk, M.D. 320 pages. $115.00. N e w York: Raven, 1990.
This is a compact book of approximately 300 pages, which is a direct result of a symposium sponsored by the Nemours Foundation. The book is edited by Steven K. Saizman, Ph.D. There are approximately 30 authors who contribute to the 17 chapters, being roughly divided into "Basic Aspects of Neural Activity and Spinal Trauma" and "Clinical Application of Electrophysiologic Methods for Intraoperative Neural Monitoring." The book appears to be a direct accumulation of all the manuscripts that were presented and has agreat deal of overlap, particularly in literature review in many of the papers, most of which have a very extensive bibliography. There are two neurosurgeons, both from New York University. Of the approximately 30 authors, two have medical degrees; the others are listed as neurologists, neurophysiologists, anesthesiologists, and pharmacologists. The purpose of the publication, as Dr. Salzman has repeatedly stated, is to emphasize in this conference that intraoperative monitoring is "state of the art" and should be required in surgery of the spinal cord. On the other hand, it is apparent that there is great variability in the opinions of various people as to what monitoring should be carried out, how reliable it is, and the problems one can find in trying to do this under all circumstances. The electrophysiologists present, Dr. Salzman said, seemed not to have known very much about what the pharmacologists-the other major group--were investigating. Dr. Salzman felt that by virtue of the intimate and lively discussions that went on, the concept ofa multimodal approach for intraoperative neuroinjury management was put forth, emphasizing a cooperative balance between anesthetic, pharmacological, surgical, and monitoring concerns. Since this symposium was held in 1988, it is impossible for the publishers to have accumulated any material since that time, but the future was anticipated to some extent by the foreword and overview by Roger Q. Cracco, a neurologist from Downstate Medical Center in New York. There is an immense amount of physiological and pharmacological data in this book, but since there was so little participation by operative surgeons, the effort of the authors to establish a policy for monitoring under operative conditions would be less than impressive at this stage.
Radiology of the Eye and Orbit, edited by Dr. Newton and Dr.
Neural Monitoring. The Prevention of
EBEN ALEXANDER, JR., M.D. Winston-Salem, North Carolina © 1991 by Elsevier Science Publishing Co., Inc.
Bilaniuk, is the fourth volume in a series of texts covering topics on neuroradiology. The publication is intended to introduce the physician (radiologist, ophthalmologist, plastic surgeon, neurologist, neurosurgeon, and otolaryngologist) to various diagnostic techniques available for the evaluation of ocular and orbital disease. The first five chapters address magnetic resonance imaging (MRI); two chapters describe the principles, techniques, and images of ultrasonography; and two chapters describe the techniques and radiographic findings of orbital disease by computed tomography (CT). MRI, ultrasonography, and CT are indispensable diagnostic tools in the evaluation of patients with ocular and orbital disease, and the presentation of all three is the major strength of the book. Chapters discussing normal anatomy seen with each of the diagnostic techniques are excellent. The radiographic images and figures are reproduced clearly and highlight well the appropriate features of the diseases under discussion. Although the editors may be congratulated for the quality of the images presented, they might be criticized for using approximately two thirds of the text to discuss MRI as the diagnostic tool of choice. With each new available technique, there is the tendency to embrace it (in this case, MRI) as being superior to the old (in this case, CT). Although MRI has indeed revolutionized the evaluation of patients with diseases of the central nervous system, this is less true for diseases of the orbit. MRI is a useful adjunct for evaluation of the orbit, but it does not supplant the use of CT. This criticism is certainly not without exception; there is an excellent discussion of MRI in the management of patients with choroidal melanoma and optic nerve disease. And, in defense of the editors, they do commonly make reference to CT findings in the chapters in which MRI findings are the subject of discussion. The emphasis on MRI is readily apparent in an entire chapter devoted to MRI of ocular diseases that are readily diagnosed by ophthalmoscopy or ultrasonography. Such diseases are rarely "imaged" by radiographic techniques such as MRI and, therefore, the text tends to become a catalog of radiographic findings. In contrast, only five pages are devoted to discussing ultrasonic diagnosis, a technique commonly used in evaluating ocular disease. The chapters discussing CT are quite helpful to the neophyte as well as to the more experienced clinician who wishes 0090-3019/91/$3.50
413
Book Reviews
Intraoperative Injury.
Modern Neuroradiology, Volume IV: Radiology of the Eye and Orbit.
Edited by Steven K. Salzman, Ph.D. 322 pages. $69.50 (U.S.)/$79.50 (export). Clifton, N e w Jersey: The H u m a n a Press, Inc., 1990.
Edited by Thomas H. Newton, M.D., and Lorissa T. Bilaniuk, M.D. 320 pages. $115.00. N e w York: Raven, 1990.
This is a compact book of approximately 300 pages, which is a direct result of a symposium sponsored by the Nemours Foundation. The book is edited by Steven K. Saizman, Ph.D. There are approximately 30 authors who contribute to the 17 chapters, being roughly divided into "Basic Aspects of Neural Activity and Spinal Trauma" and "Clinical Application of Electrophysiologic Methods for Intraoperative Neural Monitoring." The book appears to be a direct accumulation of all the manuscripts that were presented and has agreat deal of overlap, particularly in literature review in many of the papers, most of which have a very extensive bibliography. There are two neurosurgeons, both from New York University. Of the approximately 30 authors, two have medical degrees; the others are listed as neurologists, neurophysiologists, anesthesiologists, and pharmacologists. The purpose of the publication, as Dr. Salzman has repeatedly stated, is to emphasize in this conference that intraoperative monitoring is "state of the art" and should be required in surgery of the spinal cord. On the other hand, it is apparent that there is great variability in the opinions of various people as to what monitoring should be carried out, how reliable it is, and the problems one can find in trying to do this under all circumstances. The electrophysiologists present, Dr. Salzman said, seemed not to have known very much about what the pharmacologists-the other major group--were investigating. Dr. Salzman felt that by virtue of the intimate and lively discussions that went on, the concept ofa multimodal approach for intraoperative neuroinjury management was put forth, emphasizing a cooperative balance between anesthetic, pharmacological, surgical, and monitoring concerns. Since this symposium was held in 1988, it is impossible for the publishers to have accumulated any material since that time, but the future was anticipated to some extent by the foreword and overview by Roger Q. Cracco, a neurologist from Downstate Medical Center in New York. There is an immense amount of physiological and pharmacological data in this book, but since there was so little participation by operative surgeons, the effort of the authors to establish a policy for monitoring under operative conditions would be less than impressive at this stage.
Radiology of the Eye and Orbit, edited by Dr. Newton and Dr.
Neural Monitoring. The Prevention of
EBEN ALEXANDER, JR., M.D. Winston-Salem, North Carolina © 1991 by Elsevier Science Publishing Co., Inc.
Bilaniuk, is the fourth volume in a series of texts covering topics on neuroradiology. The publication is intended to introduce the physician (radiologist, ophthalmologist, plastic surgeon, neurologist, neurosurgeon, and otolaryngologist) to various diagnostic techniques available for the evaluation of ocular and orbital disease. The first five chapters address magnetic resonance imaging (MRI); two chapters describe the principles, techniques, and images of ultrasonography; and two chapters describe the techniques and radiographic findings of orbital disease by computed tomography (CT). MRI, ultrasonography, and CT are indispensable diagnostic tools in the evaluation of patients with ocular and orbital disease, and the presentation of all three is the major strength of the book. Chapters discussing normal anatomy seen with each of the diagnostic techniques are excellent. The radiographic images and figures are reproduced clearly and highlight well the appropriate features of the diseases under discussion. Although the editors may be congratulated for the quality of the images presented, they might be criticized for using approximately two thirds of the text to discuss MRI as the diagnostic tool of choice. With each new available technique, there is the tendency to embrace it (in this case, MRI) as being superior to the old (in this case, CT). Although MRI has indeed revolutionized the evaluation of patients with diseases of the central nervous system, this is less true for diseases of the orbit. MRI is a useful adjunct for evaluation of the orbit, but it does not supplant the use of CT. This criticism is certainly not without exception; there is an excellent discussion of MRI in the management of patients with choroidal melanoma and optic nerve disease. And, in defense of the editors, they do commonly make reference to CT findings in the chapters in which MRI findings are the subject of discussion. The emphasis on MRI is readily apparent in an entire chapter devoted to MRI of ocular diseases that are readily diagnosed by ophthalmoscopy or ultrasonography. Such diseases are rarely "imaged" by radiographic techniques such as MRI and, therefore, the text tends to become a catalog of radiographic findings. In contrast, only five pages are devoted to discussing ultrasonic diagnosis, a technique commonly used in evaluating ocular disease. The chapters discussing CT are quite helpful to the neophyte as well as to the more experienced clinician who wishes 0090-3019/91/$3.50