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Stereotactic neuro-radio surgery
Surgery of Vertebrobasilar Aneurysms, London Ontario Experience on 1767 Patients Drake, Peeless, Hernesniemi Springer-Verlag RRP $146 329pp ISBN 3 211 82696 3 This book represents a must for all those who regularly repair cerebral aneurysms. It represents a collection of cases predominantly by Professor Drake, the number of likes and which are almost certainly never to be equalled again. The book is organized in a very logical m a n n e r and is very easily read. Professor Drake takes us through the trials and tribulations of the surgery in these difficult locations with frank discussions on problems that he has e n c o u n t e r e d during his endeavours to pioneer and develop this surgery. This book clearly does not r e p r e s e n t and encyclopaedic account of surgery of vertebrobasilar aneurysms but m o r e importantly it reveals the e x p e r i e n c e of one man. This personal a p p r o a c h is one of the aspects of the b o o k that makes it extremely valuable. It is highly recomm e n d e d if for no o t h e r reason but a record of the thoughts, musings and achievements of this great man.
radiosurgery and convergent b e a m radiosurgery are discussed. The main section of the book deals with stereotactic radiosurgery for arteriovenous malformations and its use as a primary or secondary form of treatment for these. This is one area of radiosurgery where there is little dispute and the number of papers support this hypothesis. T h e last section of the b o o k deals with the role of stereotactic radiosurgery, both by linac and g a m m a knife systems for acoustic neuromas, brain metastases and pituitary tumours. T h e exact role of radiosurgery in these lesions remains unclear but certainly most of these papers are p r e s e n t e d as an adjunct to surgery rather than r e p l a c e m e n t for it. In the last 10 years the role of radiosurgery and t r e a t m e n t of cerebral lesions apart f r o m arteriovenous malformations has b e e n increasing and this provides some relatively up to date information on the experiences of various units in E u r o p e and the USA. T h e exact role of radiosurgery in these lesions is yet to be defined, but certainly the b o o k provides useful information for those involved in this particular field. DR MALCOLMPELL Sydney
PROF MICHAEL MORGAN Sydney
Stereotactie Neuro-Radio Surgery
Neurological Rehabilitaion, Second Edition
w. Koos, B. Richling Springer Verlag RRP $93 119pp ISBN 3 211 82657 2 1995
L. S. Ellis Blackwell Science RRP $222 581pp ISBN 0 632 03282 0 1994
This book is a collection of papers presented at the International Symposium on Stereotactic Neuro-Radio Surgery held in Vienna 1992 and represents Supplement 63 ofActa Neurochirurgica. Radiosurgery is a rapidly developing form of minimally invasive neurosurgery and the papers presented in this book reflect the concept that radiosurgery can be used not only for treatm e n t of arteriovenous malformations but also as a form of primary or adjuvant treatm e n t for gliomas, cerebral metastases, pituitary mmours and acoustic neuromas. The book opens with the role of the neuro-radiologist to stereotactic neurosurgery and the use of intra-operative landmarks for subsequent radiosurgery. The chapters on the role of stereotactic biopsy and radiosurgery and CT guided needle biopsy of tumours is probably unnecessary given that most surgeons would rely on a pathological diagnosis rather than a radiological before embarking on a radiosurgical technique. T h e r e is a g o o d overview with chapters on Indications of Brachytherapy and Interstitial irradiation for both gliomas and metastases. G a m m a knife, Linac
W h e n seeking to evaluate any addition to a professional library utility is paramount. Who will benefit from the book? Is it accessible and does it provide the means for exploring individual clinical concerns. Neurological Rehabilitation has my qualified support in this regard. It is a book primarily aimed at Neurologist,s with a bias to UK and European contributors but that weakness is also its strength in the eminently readable text. The structure of basic science discussion, topic overview then expansion chapters on specific subjects allows stepped exploration within the book itself but the contributions vary widely in their scope and depth. Inevitably it has deficits in comparison with Australian experience and little value when it mentions institutional or community resources. Fortunately there is a g e n u i n e comm i t m e n t to reinforcing issues f u n d a m e n tal to rehabilitation in any sphere; such as effective c o m m u n i c a t i o n and education, assessment in terms of impairment, disability and handicap and an appreciation of the methodological difficulties in rehabilitation research without nihilism.
378
J. Clin. Neuroscience Volume 4 Number 3 July 1997
It would be r e c o m m e n d e d simply for allowing a chapter to be devoted to the personal e x p e r i e n c e of a patient and h e r husband. Separated from the social science agenda, theirs is an articulate and valuable inclusion. A closer look at the contents provides an extensive discussion of basic science issues, stressing work on the plasticity of neural systems in recovery and learning. Unfortunately these chapters are b o u n d to be the first to lose their currency but a n u m b e r of viewpoints are e x p l o r e d and well referenced. T h e section of assessment is inadequate. These are trying times for most rehabilitation facilities and although the US health authorities have rejected FIM and the UDS system because of its 'user pays' format, many rehabilitation programmes have b e e n wrestling with externally imposed assessment procedures for many years. T h e r e f o r e the U K experience is of limited practical value. The chapters on individual neurological patient problems are quite variable with a general reliance on pharmacological treatment options and lack of clear m a n a g e m e n t algorithms. Some individual deficiencies such as the cognitive impairments in MS or the managements of autonomic dysreflexia remain, but other issues are eventually better explored in the later sections. The chapter on pain is somewhat confined to the author's own work. It neglects to assert the value of a functional diagnosis or the powerful interventions of functional restoration programmes. In the case of sexuality the explanation of available t r e a t m e n t interventions along anatomical lines is of scant help if the clinician remains u n c o m f o r t a b l e with the role of provider. So practical advice for improving the sexuality history taking would n o t have g o n e astray. T h e last section explores selected developing topics in areas such as sensory substitution and central functional electrical stimulation which m i g h t lead individuals to m o r e specific research. Overall the main criticism would be related to the editorial attempt to combine the self contained topics and the m o r e detailed explanations necessary to guide m a n a g e m e n t . T h a t clarity is not always possible, but the book as a whole is r e c o m m e n d e d because it works as an accessible reference with a g e n u i n e g r o u n d i n g in rehabilitation principles. It is likely to engage the interest of clinicians to e x t e n d their reading through general rehabilitation sources and the r e f e r e n c e d literature. IAN DAVIDSON Wollongong
radiosurgery and convergent b e a m radiosurgery are discussed. The main section of the book deals with stereotactic radiosurgery for arteriovenous malformations and its use as a primary or secondary form of treatment for these. This is one area of radiosurgery where there is little dispute and the number of papers support this hypothesis. T h e last section of the b o o k deals with the role of stereotactic radiosurgery, both by linac and g a m m a knife systems for acoustic neuromas, brain metastases and pituitary tumours. T h e exact role of radiosurgery in these lesions remains unclear but certainly most of these papers are p r e s e n t e d as an adjunct to surgery rather than r e p l a c e m e n t for it. In the last 10 years the role of radiosurgery and t r e a t m e n t of cerebral lesions apart f r o m arteriovenous malformations has b e e n increasing and this provides some relatively up to date information on the experiences of various units in E u r o p e and the USA. T h e exact role of radiosurgery in these lesions is yet to be defined, but certainly the b o o k provides useful information for those involved in this particular field. DR MALCOLMPELL Sydney
PROF MICHAEL MORGAN Sydney
Stereotactie Neuro-Radio Surgery
Neurological Rehabilitaion, Second Edition
w. Koos, B. Richling Springer Verlag RRP $93 119pp ISBN 3 211 82657 2 1995
L. S. Ellis Blackwell Science RRP $222 581pp ISBN 0 632 03282 0 1994
This book is a collection of papers presented at the International Symposium on Stereotactic Neuro-Radio Surgery held in Vienna 1992 and represents Supplement 63 ofActa Neurochirurgica. Radiosurgery is a rapidly developing form of minimally invasive neurosurgery and the papers presented in this book reflect the concept that radiosurgery can be used not only for treatm e n t of arteriovenous malformations but also as a form of primary or adjuvant treatm e n t for gliomas, cerebral metastases, pituitary mmours and acoustic neuromas. The book opens with the role of the neuro-radiologist to stereotactic neurosurgery and the use of intra-operative landmarks for subsequent radiosurgery. The chapters on the role of stereotactic biopsy and radiosurgery and CT guided needle biopsy of tumours is probably unnecessary given that most surgeons would rely on a pathological diagnosis rather than a radiological before embarking on a radiosurgical technique. T h e r e is a g o o d overview with chapters on Indications of Brachytherapy and Interstitial irradiation for both gliomas and metastases. G a m m a knife, Linac
W h e n seeking to evaluate any addition to a professional library utility is paramount. Who will benefit from the book? Is it accessible and does it provide the means for exploring individual clinical concerns. Neurological Rehabilitation has my qualified support in this regard. It is a book primarily aimed at Neurologist,s with a bias to UK and European contributors but that weakness is also its strength in the eminently readable text. The structure of basic science discussion, topic overview then expansion chapters on specific subjects allows stepped exploration within the book itself but the contributions vary widely in their scope and depth. Inevitably it has deficits in comparison with Australian experience and little value when it mentions institutional or community resources. Fortunately there is a g e n u i n e comm i t m e n t to reinforcing issues f u n d a m e n tal to rehabilitation in any sphere; such as effective c o m m u n i c a t i o n and education, assessment in terms of impairment, disability and handicap and an appreciation of the methodological difficulties in rehabilitation research without nihilism.
378
J. Clin. Neuroscience Volume 4 Number 3 July 1997
It would be r e c o m m e n d e d simply for allowing a chapter to be devoted to the personal e x p e r i e n c e of a patient and h e r husband. Separated from the social science agenda, theirs is an articulate and valuable inclusion. A closer look at the contents provides an extensive discussion of basic science issues, stressing work on the plasticity of neural systems in recovery and learning. Unfortunately these chapters are b o u n d to be the first to lose their currency but a n u m b e r of viewpoints are e x p l o r e d and well referenced. T h e section of assessment is inadequate. These are trying times for most rehabilitation facilities and although the US health authorities have rejected FIM and the UDS system because of its 'user pays' format, many rehabilitation programmes have b e e n wrestling with externally imposed assessment procedures for many years. T h e r e f o r e the U K experience is of limited practical value. The chapters on individual neurological patient problems are quite variable with a general reliance on pharmacological treatment options and lack of clear m a n a g e m e n t algorithms. Some individual deficiencies such as the cognitive impairments in MS or the managements of autonomic dysreflexia remain, but other issues are eventually better explored in the later sections. The chapter on pain is somewhat confined to the author's own work. It neglects to assert the value of a functional diagnosis or the powerful interventions of functional restoration programmes. In the case of sexuality the explanation of available t r e a t m e n t interventions along anatomical lines is of scant help if the clinician remains u n c o m f o r t a b l e with the role of provider. So practical advice for improving the sexuality history taking would n o t have g o n e astray. T h e last section explores selected developing topics in areas such as sensory substitution and central functional electrical stimulation which m i g h t lead individuals to m o r e specific research. Overall the main criticism would be related to the editorial attempt to combine the self contained topics and the m o r e detailed explanations necessary to guide m a n a g e m e n t . T h a t clarity is not always possible, but the book as a whole is r e c o m m e n d e d because it works as an accessible reference with a g e n u i n e g r o u n d i n g in rehabilitation principles. It is likely to engage the interest of clinicians to e x t e n d their reading through general rehabilitation sources and the r e f e r e n c e d literature. IAN DAVIDSON Wollongong