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University of North Carolina Chapel Hill, NC 27599-7510
By A. James Barkovich. Philadelphia: Lippincott Williams & Wilkins, 850
pp., 2000. $175
The first chapter, describing techniques and methods, now includes diffusion, perfusion, and spectroscopy. Of these, diffusion has had a considerable impact on the detection of neonatal infarctions, and spectroscopy clearly aids in the characterization of tumors and metabolic disorders. The worldwide interest in imaging of the fetal brain and spine is partly reflected by its inclusion in the chapter on normal development. The number of toxic and metabolic abnormalities presented has increased since the previous edition, probably reflecting the growth of the author's collection of these rare disorders.
The chapter on injuries of the brain and spine includes not only those of traumatic origin but also infarctions and some metabolic disorders. Congenital malformations of the brain are presented in a masterful fashion as they should be, representing the cornerstone on which pediatric neuroradiology has been erected. The neurocutaneous syndromes are well discussed, with appropriate emphasis on the more common ones such as neurofibromatosis and tuberous sclerosis. Tumors are not strictly separated by anatomic locations (as in other textbooks), but all of those arising in the brain, orbits, and neck are compiled in the same chapter. Hydrocephalus is a common entity though, a poorly understood one. A full chapter has been dedicated to this complex topic and hopefully will enable the reader to understand it better.
Although it is my impression that in the United States congenital anomalies of the spine are slowly disappearing (probably because of widespread use of prenatal vitamins and the administration of folic acid before and after conception), this subject constitutes a large chapter in the book. The theme of spinal congenital defects is a complex one, explained with style and clarity. Physicians from regions where these anomalies are still relatively common will undoubtedly benefit from reading this chapter, whereas those of us living in the United States will continue to refer to it when faced with one of these disorders.
Following the chapter on spinal congenital anomalies with one on spinal tumors (both inside and outside the spinal cord) gives the book some continuity. Then the author returns to a chapter on infections of the nervous system, which comprises only a few pages on spinal infections. The last chapter, "Anomalies of the Cerebral Vasculature," is the only one not written exclusively by Dr. Barkovich. It suitably discusses the imaging of these vascular lesions and also provides some information on their endovascular therapy. I am not sure that this last chapter benefits the overall content of the book, but it does not subtract from it either.
The text is referenced and the citations at the end of each chapter are extensive and mostly up-to-date (a caveat to all books authors). Currently no book competes with this one. Most other textbooks dedicated to pediatric neuroradiology are outdated. This book is not cheap, but those who interpret images of the pediatric brain and spine will probably buy it regardless of its price. It is well worth purchasing even if one already owns the two prior editions.
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