Mukherji SK, Salamon N. Neuroimaging Clinics of North America: Headache and Chiari Malformation. Theclinics.com 2019;29:203-324;$386.90.

While the title of the issue of Neuroimaging Clinics: Headache and Chiari Malformation doesn’t sound like the issue would contain new information, many chapters contain usable and practical points. Edited by Dr. Noriko Salamon with 34 contributors, there are 9 chapters (123 pages) with subject material that neuroradiologists deal with on a near daily basis. Of particular interest, are the chapters on intracranial hypotension and CSF leaks, where the imaging findings are reviewed, and importantly, where techniques such as DSM are described to detect small leaks. Excellent images are included in this chapter to show leaks into paraspinal veins— a finding probably not identifiable on other imaging studies. Described and illustrated are clinical management tools such as conservative/ non-interventional blood patching, targeted interventions with fibrin glue, and if other approaches fail, open surgery with the latter, in addition to classifications of types of leaks and how they may be dealt with.

Headaches are common, and sinus disease is also common, so the dilemma is to determine in any one given patient if these are related. The chapter on this subject goes into potential neural pathways involved where they are accompanied by proper drawings and images.

Other chapters will be of interest, particularly one which correlates the presence of a patent foramen ovale with migraines. The topics adequately cover the subject at hand via an economic and appropriateness overview of neuroimaging and headaches, the Chiari I Malformation and pattern of headaches, aneurysms, pediatric headaches, brain tumors, and advanced imaging techniques in migraine evaluation.

For those who are interested in seeing the key work that has been done in this area, three tables are available in the latter chapter, encompassing 15 pages.