Abstract
Clinicians might ask if there is a need for another book on Stroke. This 275 page tome, scribed by stroke clinicians at the forefront of clinical research from both sides of the Atlantic, fits nicely between the quick question/answer type book and the more comprehensive reference book. It presents an excellent blend of clinical experience and research. As a co-authored rather than co-edited work, it has the advantage of more consistent style and minimal repetition. In addition, the authors have chosen an interpretive approach rather than a didactic review of the literature. As such, they have listed key references and suggested further reading at the end of each chapter.
The book is handsomely produced with a glossy red hard cover. The first few pages contain a number of beautiful colour plates, including images obtained from cutting-edge technologies. The book is well illustrated with diagrams and images.
The book is easily read cover-to-cover. The authors state in the preface that stroke medicine is a fascinating specialty, and this enthusiasm is maintained all the way through. The material is organised into three sections: clinical approach, causes, and treatment. While this works reasonably well, some chapters seem a little out of place. Material in each chapter is organised under headings and sub-headings and there is a comprehensive index, so that the book can be used for quick reference.
The chapter on rare causes of stroke contains some succinct paragraphs about many interesting disorders, clearly indicating the authors' depth of clinical experience.
There are a few criticisms including inaccuracies in some of the diagrams depicting the circle of Willis. In the risk factors section, atrial fibrillation, carotid stenosis, diabetes and hypertension should be covered in more detail. The chapter on ‘Vascular Dementia’ would have been better entitled ‘Vascular Cognitive Impairment’ as there is still debate about whether stroke leads to progressive decline in cognitive function. This chapter could also have contained a better description of the different mechanisms of vascular cognitive impairment and a discussion on the role of vascular mechanisms in the pathogenesis of Alzheimer's disease. Overall this is an excellent text and I think it should be on the list of essential reading for any stroke registrar as well as clinicians for whom stroke is an important but not primary component of their caseload.