Spetzler RF, Nakaji P, Rhoton Jr AL, et al. Color Atlas of Cerebral Revascularization. Thieme; 2013; 386 pgs.; 826 illustrations; $249.99.
Patients with complex cerebrovascular diseases requiring cerebral revascularization represent a diverse population of individuals, each with unique anatomy and pathology. The complexity of these cases requires significant experience in the management of these disorders, as well as technical proficiency in the completion of the bypass procedure. The Color Atlas of Cerebral Revascularization is a well-organized and extremely detailed review of the bypass procedures available to neurosurgeons. Due to the highly detailed technical nature of the subject material, this text is directed toward the neurosurgical audience. The methodical step-by-step presentation is ideal for neurosurgical residents, yet also acts as an excellent reference for experienced surgeons. Additionally, the clear and concise presentation, detailed pictures and illustrations, and inclusion of radiographic imaging and clinical scenarios make this text a valuable resource to neuroradiologists-in-training and those already in practice.
Multiple books and chapters are currently available that detail the bypass procedures employed in contemporary neurosurgery. The Color Atlas of Cerebral Revascularization possesses three distinct advantages over the majority of these texts. The first is the comprehensiveness of the material, which includes nearly every bypass currently in use, both those commonly and more rarely employed. Secondly, the systematic and stepwise presentation of the technical aspects of the procedures has not been duplicated elsewhere. Each chapter begins with a review of the pertinent anatomy, then details the surgical exposure of the pathology, and concludes with the microsurgical technique utilized in preparing and completing the bypass. Throughout the book, the authors utilize anatomical dissection specimens from the Rhoton collection. These specimens allow the reader to visualize important anatomical relationships that are difficult to appreciate intraoperatively.
Finally, and most importantly, the images are second-to-none in their ability to present the subject material. All intraoperative photographs are paired with a clearly drawn and labeled illustration that clarifies the anatomy, the preparation of donor and recipient vessels, and the completion of the bypass. The legends, which are descriptive and succinct, complement the images and add an additional element of clarity. Surgical atlases commonly force the reader to decipher what the operative photograph is attempting to depict, whether it is due to poor image quality, a lack of clear labeling, or simply the extreme complexity of the procedure. The authors have eliminated this “guess work,” making the atlas an efficient and informative read. It is this pairing of operative photographs with high-quality illustrations that raises this text to a level superior to that of its competitors.
Pathology requiring cerebral revascularization is usually highly complex in nature and seldom encountered on a routine basis. Perhaps the greatest utility of the atlas to the neuroradiology audience is found in the quality of the radiographic imaging, including CT/CTA, MRI/MRA, and angiography that highlight these particularly rare entities. The majority of chapters begin by presenting the imaging of the pathology at the time of diagnosis (CT and MRI). Preoperative angiograms are also routinely used throughout the text. Chapters conclude with a postoperative angiogram that highlights the elimination of the pathology and the restored blood flow post-bypass. When combined with clinical scenarios and the bypass used to treat the lesion, neuroradiology residents and fellows will surely benefit from a more global understanding of the disease and its treatment.
The entire text is a compilation of the vast clinical experience of the authors and their in-depth expertise in the fields of neuroanatomy, microsurgical technique, and cerebral revascularization. As a result, the end product is uniquely theirs and does not draw from a breadth of sources or reference the current literature. There are, in fact, no references listed, and anyone interested in additional resources for further reading will have to consult an additional text. This lack of references is not a detraction, as the book does not aim to summarize all aspects of patient care and surgical management. The text, instead, benefits from the absence of management controversies, differing opinions, and statistical data. The Color Atlas of Cerebral Revascularization has a goal of presenting a “user-friendly” neuroanatomical surgical atlas, and it accomplishes that in its simplicity and straightforward nature.
The Color Atlas of Cerebral Revascularization is a well-composed atlas that emphasizes heavily the microsurgical techniques and anatomical aspects of cerebral revascularization procedures. It is undoubtedly geared to address primarily neurosurgical residents and fellows, who will use this book as a training manual, and to the experienced neurovascular surgeon aiming to refine their technique. For this audience, the atlas is highly recommended, as it has significant advantages when compared to texts addressing identical subject matter. Additionally, audiences from other specialties, including neuroradiology and neurology, will find the book to be a valuable complement to the primary literature in their respective fields. Through the detailed descriptions of each individual bypass, the reader will gain a greater appreciation of the imaging findings associated with complex neurovascular pathology.
