Rangel-Castilla L, Nakaji P, Siddiqui AH, et al. Decision Making in Neurovascular Disease. Thieme; 2018; 528 pp; 310 ill; $249.99.

Decision Making in Neurovascular Disease is a 71-chapter single-volume reference with information, illustrations, and treatment algorithms on neurovascular pathologies that may be encountered in the brain or spine.

This comprehensive book is organized into seven sections:

• Ischemic stroke and vascular insufficiency;
• Aneurysms (anterior circulation, posterior circulation, other);
• Arteriovenous malformations;
• Fistulas;
• Cavernous malformations;
• Hypervascular tumors.

Each chapter includes pathophysiology, clinical and radiographic imaging evaluation, differential diagnoses, decision-making algorithms, as well as considerations in surgical and endovascular treatments.

Treatment of neurovascular disease has become a multi-disciplinary field including neurology, radiology, and neurosurgery. The value of this book is that it summarizes the most up-to-date and important evidence in the literature for management of each specific condition. Using this information, the authors construct a simplified decision tree to facilitate evidence-based treatment.

The operative nuances section briefly mentions the various techniques within each modality (surgery, endovascular, radiosurgery) that may be used. In this way, it serves as a catalog of the contemporary technology and techniques within each modality at this time, which is particularly useful in the rapidly evolving endovascular field. However, other texts may serve as a more useful guide for the specific detailed technical aspects of how to perform the surgical or endovascular procedure.

Each chapter also contains key neuroimaging with case examples or illustrations of important anatomical relationships. The beautiful color illustrations of the spinal arteriovenous malformations are particularly noteworthy in detail and clarity.

As most of the chapters are written by neurosurgeons or neurointerventionalists, it is important to recognize that there may exist a slight bias towards treatment over observation. Nevertheless, the expert commentary at the conclusion of each chapter provides additional thoughtful counterpoints as well as reflections of this evolving field from the most experienced in the community.

This book would certainly broaden any neurointerventionalists understanding of neurovascular disease and treatment approaches. It serves as a particularly useful textbook for any trainee seeking to be involved in the care of patients with neurovascular diseases.