Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6^th Edition, Vol. I: Principles of Diagnosis and Management, Vol. II: Neurological Disorders. Elsevier Saunders 2012, 2544 pages, $499.

It becomes an achievement of significant magnitude when a classic textbook bears the name of the original founding editor and the title is identified primarily by the name of that person. This elevated status is now conferred to Dr. Bradley with this new (2012) two-volume text, which is now known as Bradley’s Neurology in Clinical Practice, named after Walter G. Bradley, Chairman Emeritus at the University of Miami School of Medicine.

The current editors, Drs. Daroff, Fenichel, Jankovic, and Mazziotta, have assembled a group of over 182 authors, who together have authored the definitive text in Clinical Neurology. Volume I (892 pages, exclusive of an extensive “principles of” index in both volumes), Principles of Diagnosis and Management, is intended to lay the ground for Volume II (1268 pages), which describes specific neurological disorders. It should be noted that this entire publication is searchable online, and access is available with an activation code that comes with the book.

Volume I, although holding less interest for a neuroradiologist compared to Volume II,  nonetheless has chapters of importance. From the 30 chapters in Volume I, I can point to a number which would have day-to-day applicability to our specialty. To cite a few examples, these would include language and speech disorders, abnormalities of the optic nerve and retina, brainstorm syndromes, arm/neck pain, including a nice review of brachial plexus anatomy, low back/limb pain (with a review of the lumbosacral plexus), neuro-ophthalmology/neuro-otology, among many others. While most of the chapters in Volume I are well done, the chapter entitled “Principles of Neurosurgery” is so cursory that it is useless.

For both volumes, references are not printed out at the end of each chapter but are, rather, available online with the individual activation code. It is of passing interest that five chapters on neuroimaging are authored by neurologists (i.e. neuroimagers), not neuroradiologists, with the exception of the interventional chapter co-authored by Fernando Viñuela. There is considerable overlap between that chapter and the one entitled “Principles of Endovascular Therapy,” which was written by 4 neurosurgeons. The 128 pages (chapters 33A-E) on imaging are appropriately constructed for a textbook in Neurology. However, this is not a reason for a neuroradiologist to be interested in this text; rather, our interest would be in the non-imaging clinical information.

It is Volume II, entitled Neurological Disorders, which will hold the greatest interest to the neuroradiology community. There are 34 major chapters, and some have subchapters, giving a total of 52 separate subjects, all of which are dealt with in an authoritative and complete manner. Each chapter begins neatly with an outline of what is to follow, allowing fast identification of one’s particular interest or inquiry. With the activation code, there are video clips accessible for review on the internet. Since neuroradiologists rarely, if ever, encounter the patient behind the images, we can now view many of the clinical consequences of the diseases described in the text. This is particularly useful in movement disorders, cranial neuropathies, and in neuro-ophthalmological disorders.

Volume II begins nicely with two survey chapters on the neurological complications of adult and pediatric diseases. Interestingly, one of the 4 chapters on nervous system trauma includes one on peripheral nerve trauma (18 pages), which, along with the 100-page chapter much later in “Disorders of Peripheral Nerves,” will allow quick reference to diseases which we may eventually be called on to evaluate. The fine chapter on Vascular Disease (100 pages) includes ischemia, hemorrhage, SAH, childhood stroke, vascular disease spine, and vasculitis. Seven chapters on tumors and four on Infections are excellent, incorporating gross and histologic specimens, in addition to the clinical manifestations, in the descriptions. Take for example the excellent chapter by Verna and Berger on HIV manifestations. Here you have it at your fingertips: tables and charts showing the classification HIV infection, potential disease progression, drugs for treatment according to classification, anatomic localization of the diseases associated with HIV, and therapies for specific HIV associated diseases. This reviewer is, however, surprised that the authors failed to include images of spinal cord lesions associated with HIV—vascular myelopathy in particular, since it is so commonly seen. And they included very dated MR images in HIV dementia. As in all publications, care must be taken to exclude all patient identifiers, yet this was not done in a patient with a subdural empyema.

The chapters that follow are all germane to neuroimaging: MS and other demyelinating diseases, hypoxic/anoxic encephalopathy, toxic/metabolic disorders, developmental brain disorders, other diseases which most often manifest in childhood, such as inborn errors of metabolism or mitochondrial disorders. In these aforementioned chapters, do not expect robust (or any) imaging; rather, it is for the basic disease processes that the book is of value. The same applies to the chapter on channelopathies, which we are recognizing as mimickers or parts of other disease, such as those within the limbic encephalitis group. This authoritative chapter allows one to gain an appreciation of the underlying pathologic mechanisms in channelopathies. Since we are increasingly asked to evaluate patients with dementia, the 48-page chapter on dementias is likewise important. There are even chapters which have nothing to do with imaging, like the 2 chapters on sleep disorders, but which everyone would find interesting.

The books are outstanding and, of course, one would expect nothing less when such a publication has as its lead editor Dr. Robert Daroff. This is highly recommended as a personal copy for all practicing neuroradiologists, or, at the very minimum, this two-volume set should find its way to the shelf of every Neuroradiology Section’s library.