Stroke: Pathophysiology, Diagnosis, and Management, 4th Edition

Stroke: Pathophysiology, Diagnosis, and Management, 4th Edition

J. P. Mohr, MS, MD, Dennis W. Choi, MD, PhD, James C. Grotta, MD, Bryce Weir, OC, MD, FRCSC, FACS, FRCSEd (Hon), and Philip A. Wolf, MD. Churchill Livingstone, Philadelphia, 2004. ISBN: 0-443-06600-0, $299.00.

Scope: This is a comprehensive presentation of clinical manifestations of stroke, differential diagnosis, and treatment. It is an ongoing work dating back to the first edition in 1988; then it was entitled Clinical Epidemiology of Stroke. This fourth edition, led by Jay P. Mohr, MD and four new editors, expands on the third edition (1998) with a review of recent knowledge and a new section on the epidemiology of stroke edited by Philip A. Wolf, MD. The contributors are internationally diverse.

The book is divided into six sections: Epidemiology and Prevention, Clinical Manifestations, Diagnostic Studies, Specific Medical Diseases and Stroke, Pathophysiology, and Therapy. The sections are separated by colored tabs. Each chapter within these sections has its own references.

Strengths: This is a thorough, well-organized review of current thinking and issues relating to stroke, and it does an excellent job of presenting each subject with clarity and ample supporting clinical studies. This style lends itself to reading as a narrative and reference source.

Weaknesses: A minor weakness of the text is that a reader seeking specific answers to a question may have to review several different sections. For instance, for information on the epidemiology of subarachnoid hemorrhage, the reader will have to read the Epidemiology section and the epidemiology subsection of the Special Medical Disease and Stroke chapter. Also, each thumbed section could benefit from a Contents introductory page, with abbreviated titles and page numbers distilled from the book's main table of contents.

Recommended Audience: Physicians of any specialty, including family practice, internal medicine, neurology, physical medicine and rehabilitation, and especially neurology residents and interns, general ophthalmologists, and neuro-ophthalmologists.

Critical Appraisal: I highly recommend this text to neuro-ophthalmologists. Discussions of specific neuro-ophthalmologic diseases and ocular manifestations of stroke are interspersed throughout the text, such as in chapters on vertebrobasilar disease and carotid disease. These portions are brief, accurate, and well-written. Perhaps a future edition will contain a contribution from a neuro-ophthalmologist in its own chapter.

Mitchell Gossman, MD

St. Cloud, Minnesota