Tsao JW, Ed. Traumatic Brain Injury: A Clinician’s Guide to Diagnosis, Management, and Rehabilitation. Springer; 2012; 339 pages; 63 illustrations; $209.
Traumatic Brain Injury: A Clinician’s Guide to Diagnosis, Management, and Rehabilitation examines the complexities of cerebral trauma from a clinician’s perspective and discusses subjects ranging from the initial diagnosis and management of traumatic brain injuries (TBI) to their long term consequences and treatments. The book is well written for any clinician involved with TBI and contains an extensive literature review with modern, evidence-based observations and recommendations.
Although each chapter presents basic information, the true strength of this book is the comprehensive appraisal of the topic that spans the many medical specialties involved in TBI care. For the neurosurgeon and neuro-critical care specialist the management of moderate to severe TBI is accurate and consistent with the current guidelines, but offers little new data for them. However, topics such as the long term effects of mild TBI, sports-related injuries, and neurological rehabilitation may be outside the realm of their day-to-day practice and are worth reviewing. The good organization of each chapter, each of which includes an abstract and a summary, is very helpful.
Since an understanding of the lifelong, long-term consequences for cerebral trauma are extremely important for primary care and neurocognitive specializations, these specialists would benefit most from this book. For the neurologist, the neurocognitive effects of TBI, headaches, and seizures are presented. The expanding field of sports medicine will certainly be interested in the short- and long-term effects of concussions as well as the current guideline for clearance and “return to play.” Additionally, the sleep-wake disturbances in TBI patients would interest many, while the long term cognitive, psychological, and physical disabilities in TBI are well reviewed for psychiatrists and rehabilitation doctors. The text is written in a simple and understandable fashion with clinically relevant topics that may directly improve the care of these patients.
One topic that is unique to this book is the inclusion of military head trauma. This section addresses the common major injuries in modern warfare, such a Blast TBI, and Penetrating TBI. In this excellent chapter, Tsao et al include extensive data on combat-related injuries and their unique consequences, such as post-traumatic stress disorder.
From a neuroradiologist’s perspective, the role of modern neuroimaging is intimately related to the diagnosis and prognosis of TBI. However, the neuroradiology chapter and individual sections within other chapters that examine the imaging of traumatic brain injuries are much simplified and insufficient as a sole source of information for Neuroradiologists, though they may be very useful to the general radiologist, especially those in Level One trauma centers.
As a teaching tool, this book serves as a great starting point for trainees unfamiliar with TBI. The text and figures are easy to understand and well organized. The text describes and emphasizes computed tomography (CT) findings, which remain the “gold standard” in neurotrauma imaging and the principle tool for clinical decision-making. Magnetic resonance imaging (MRI), which remains an important tool for prognosis, is also addressed, and new technologies such as MR spectroscopy, perfusion MRI, magnetic source imaging, positron emission tomography, and single photon emission tomography are discussed. Although these techniques have yet to become routine in the care of these patients, novel imaging methods hold promise for future clinical practice. For example, the authors address the potential for identifying subtle changes on studies such as diffusion tensor imaging and functional MRI in mild TBI patients who, in the past, would have been assumed to be physiologically and structurally normal.
Overall, Traumatic Brain Injury: A Clinician’s Guide to Diagnosis, Management, and Rehabilitation is an excellent clinical overview based on the modern literature. Some guidelines are provided, but the true strength comes from collecting contemporary, well referenced chapters from experts in all the major TBI-associated subspecialties in a single book.
