Vol. 4. pp 349-350. 1986
0 Handbook of Critical Care Neurology and Neurosurgery. Edited by Robert J. Henning and David L. Jackson. 288 pp. Praeger Publishers, New York, 1985, $39.95. A variety of books on neurological and neurosurgical intensive care have been published in the last five years. Neurological and Neurosurgical Intensive Care,’ Intensive Care for Neurological Trauma and Disease,2 and Critical Care of Neurologic and Neurosurgical Emergencies3 are multiau-
thored texts that evolved from continuing medical education conferences. Neurologic Emergencies! and Neurologic Emergencies in Infancy and Childhood’ are more broadly based and less oriented to the intensive care unit. The first cited text is authored mostly by physicians from one institution, the Massachusetts General Hospital. The reviewed text, Handbook of Critical Care Neurology and Neurosurgery, similarly is written by physicians predominately from one institution, Case Western Reserve University. Neurologists, neurosurgeons, internists, and radiologists are among the contributors. The stated purpose of the text is to serve the practicing physician with a useful current reference book on accepted techniques available for the diagnosis and treatment of acute nervous system illnesses with a bias toward the critical care unit. The discussions tend to be well-written general overviews, many by recognized authorities in the field. Radiographs, when included, are satisfactory in quality; illustrations are too infrequently used.
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The chapter on neurological evaluation of the critically ill patient offers a good management strategy and nicely summarizes a thorough physical examination. The chapter shares a deficit with most other works cited above in that the discussion of acute airway management is limited to recommending “careful attention to the airway.” Cervical spine protection and evaluation is not mentioned in this chapter and only briefly throughout the book. Some topics are included in this book that are omitted from most similiar books. Chapters on neurologic implications of cardiopulmonary resuscitation and emergency management of neuromuscular disease are interesting and appropriate for inclusion. The chapter on treatment of tonic-clonic status epilepticus offers a protocol that by author’s admission is his somewhat personal approach to the problem. The protocol is clearly stated and well defended. The discussion includes specific treatment recommendation and is excellent. Another strong chapter covers increased intracranial pressure; the same author also discusses this topic in two of the other texts cited above. Coverage of acute head trauma is surprisingly brief. The chapter on alcoholrelated disorders is unexpectedly detailed. Blood pressure control is mentioned, but only briefly discussed in chapters on stroke and subarachnoid hemorrhage. Toxic etiologies of CNS disturbances are mentioned only in passing. Specific pediatric problems or management of the pediatric patient are not included. Emergency department
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stabilization and evaluation are not specifically addressed. This book is similar in content to several of the texts cited above. I would recommend it to someone with special interest in clinical neurosciences or to a resident on an intensive care rotation for a concise overview of the area. The text from the Massachusetts General Hospital’ addresses airway management, monitoring, and increased intracranial pressure in more detail but omits some specific topics, e.g., status epileptic-
us. Discussions on specific clinicial entities are generally more detailed in the text from the Barrow symposium,3 but that text and its references are now several years old. For a readable, more emergency medicine oriented text I would recommend the volume on pediatric emergencie9; most of the text is applicable to the adult patient as well. J. Stephen
of Emergency Medicine University of Cincinnati
REFERENCES 1. Ropper AH, Kennedy SK, Zervas NT: Neurological and Neurosurgical Intensive Care. Baltimore, University Park Press, 1983. 2. Green BA, Marshall LF, Gallagher TJ: Intensive Care for
York, Academic Press, 1982. 3. Thompson RA, Green JR: Critical
logic and Neurosurgical
Raven Press, 1980. 4. Earnest MP: Neurologic Emergencies. New York, Churchill Livingstone, 1983. 5. Pellock JM, Myer EC: Neurologic Emergencies in Infancy and Childhood. New York, Harper and Row, 1984.