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Hans-Joachimand Kretschmann, Wolfgang Weinrich Thieme: Stuttgart. 2004 451 pp. $199 3-13-672603-0.
Cranial Neuroimaging and Clinical Neuroanatomy is a neuroscience resource book for daily clinical practice, comparable to a laboratory manual that is used in the daily routine at the lab bench. It is a book that provides a comprehensive, exhaustive reference for determining the correlation of morphology and function of the central nervous system with its surroundings, not only for neurologists, neurosurgeons, and neuroradiologists but also for neuroanatomists and neuropathologists.
Formally, this third edition is made up of seven main chapters that are followed by three additional chapters containing materials and methods, references, and an index that allows easy retrieval of information. Presented first are an introduction, which sketches concisely the rules of the imaging modalities and presents the anatomical principles and guidelines, and a second chapter, which briefly introduces the imaging techniques. What follows is a nearly 200-page atlas containing scans and schematic anatomical drawings. Unfortunately, the table of contents does not indicate that the atlas is complemented with a list of page references to the numerous figures that can be easily found in the front and back of the volume, underscoring the book’s value as a resource for daily practice. Thereafter, Chapter 6 contains a pragmatic correlative description of vascular supply territories and of cortical functional anatomy and fiber tracts, with functional anatomy related to systems such as the visual or olfactory. The atlas and text portion of the book concludes with a short chapter on basic neurosciences, iterating the various neurotransmitter systems.
The book is very well illustrated throughout, with very high quality scans and accompanying drawings. In the atlas chapters, anatomical drawings are placed side by side with either MRI scans or CT scans, so that the soft tissue information is presented as well as, where necessary, the information on the bony structures. Handling the atlas pages of the book is convenient because they are color coded to subdivide the coronal, sagittal, canthomeatal, and brainstem slices. Altogether, there are 151 figures, many of which are made up of four or more sub-panels, so that the total number of individual plates is close to 800. Print quality, scan resolution, and plasticity of the drawings are excellent, augmented by the color coding. Figure 91a–d (altogether ten panels), depicting the vascular anatomy of the brain, is exemplary for this superb achievement of the merging of a multiplicity of diverse anatomical information. With the illustrations from this book, any lecture to medical students, be it in neuroanatomy or functional neurology or neuroradiology, would offer a maximum of integrated information, easily conveyed with the abundance of correlative information that is provided.
This book is not a textbook in the classical sense, that is, one that can be read and studied. It serves its purpose during the moments that are common to all of practical clinical neuroscience when a myriad of information must be quickly correlated. In a real-life situation, when looking at a scan with a certain cranial pathology, the student, nurse, technician, or doctor will be able to define the lesion in all its anatomical and functional aspects. By using the atlas between pages 22 and 210, including the coronal, sagittal canthomeatal, and brainstem slices, the anatomical relationship of a lesion can be exactly anatomically defined. It deserves extra mention that the structures outside the cranial vault, like the nasal cavity, paranasal sinuses and orbit, and many aspects of the oral cavity and neck region, are included in Chapters 3 and 4, so that complex skull base lesions and injuries can also be anatomically correlated. The main emphasis, though, is on the central nervous system and its functional integration. Since any lesion within the central nervous system has functional implications, a large part of the book is devoted to functional anatomy. Based again on the multiplanar slice system introduced in the atlas chapters, the functional organization of the brain regions and their connection via fiber tract systems is shown in Chapters 5.7 to 6.12 and can be easily cross-referenced throughout the book.
The usefulness of this book in daily practice is well established, and the “Thieme Classics” title is well deserved. Some examples of typical clinical situations in which the book is useful are stroke, encephalitis, and tumors. Our Center for Clinical Neurosciences at the University Hospital Eppendorf in Hamburg serves as a referral for all these conditions. When, for example, stroke is clinically suspected and then diagnosed by imaging, a junior house officer can completely understand and correlate clinical signs, functional organization, and imaging aspects of that individual patient. The same is true for a patient presenting with an intrinsic brain tumor. This may explain why the previous editions of the book are found on almost every bookshelf and are literally falling apart from wear and tear, being reinforced with tape to extend their lifespan, which is pushed to the limit by daily use. For neurosurgeons and neuro-oncologists who may be faced with counseling patients about the risk of surgical interventions for tumor, the book provides an excellent basis for assessing risk and discussing it with the patient, even using the illustrations to comfort the patient in the case of minimal risk or to support a decision against any aggressive resective procedure because of the complex consequences.
Overall, this book is extremely useful in the daily practice of neurotherapists, who must constantly correlate clinical and neuroradiological findings. The book is certainly not for students because it is far too specialized, but it is very instructive for any serious clinical neuro-scientist. Compared to other books of similar content, the quality of the book and its illustrations is a superb value for the cost, making it affordable for the interested individual.