Grand W, Hopkins LN, Siddiqui AH, et al. Vasculature of the Brain and Cranial Base. 2nd ed. Thieme; 2015; 350 pp; 621 ill; $189.99
This book presents detailed information on neurovascular anatomy of the head in concise, easily digestible chapters that focus on the importance of understanding normal anatomy and its variants, with an emphasis when performing neurointerventional procedures.
This second edition is comprised of 10 different chapters. The first chapter, “Basic Anatomy”, is an overview of the skull, skull base, and brain. Chapters 2–9 then go into the details of a distinct artery/arteries of the head or anatomical region of interest. These chapters include: “External Carotid Artery” (Chapter 2), “Internal Carotid Artery” (Chapter 3), “Carotid-Ophthalmic Triangle” (Chapter 4), “Posterior Communicating Artery and Anterior Choroidal Artery” (Chapter 5), “Middle Cerebral Artery” (Chapter 6), “Anterior Cerebral and Anterior Communicating Arteries” (Chapter 7), “Basilar Bifurcation and Posterior Cerebral Arteries” (Chapter 8), and “Vertebral and Basilar Arteries” (Chapter 9). The last chapter is dedicated to “Venous Anatomy” (Chapter 10).
The general outline of each chapter is uniform throughout the book. The organizational presentation of each chapter follows a coherent approach, with succinct text accompanied by annotated images. After a short introduction about the vessel to be discussed in each chapter, the branches of the artery are then discussed separately, with a description of how they course, the relationship with other structures, variations, and often times, clinical importance. Anatomic variations are not given as percentages but rather are mentioned as “frequent”, “uncommon”, and “rare”. As previously stated, detailed illustrations depicting the vessel being reviewed accompany the text. Frequently there are pictures of cadaveric dissections also depicting the vessel of interest and its relationship with adjacent structures. In vivo pictures of surgical dissections and photomicrographs of specimens are also included in the majority of the chapters. This approach serves as reinforcement of the key facts pertaining to the vessel being reviewed, going from explanatory text to a more visual understanding. Images are of great quality and are clearly labeled.
Toward the end of each chapter, there is always a section titled “Clinical Cases”. This is perhaps the best feature of the book. This section illustrates examples of relevant pathology related to the artery previously discussed in the chapter. Each case opens with a brief clinical history followed by some noninvasive imaging (CT, MRI, etc) and then more emphasis on cerebral angiography and neurointerventional treatment of the entity. Finally, at the end of this section are the “Clinical Pearls”. These typically consist of a dedicated page of bulletpoints of the most clinically relevant details of each vessel, its branches, and/or vascular territory.
I would offer a different way of reading each chapter: rather than reading it in order, start with the “Clinical Cases” section. Try to solve the case as you would when confronted with a patient presenting with a similar situation, before proceeding to how it was treated; self assess what knowledge you lack to tackle the disease presented and then read the chapter before finishing off with how the particular case was resolved. Give the clinical case a second try and then read and understand how the authors approached it.
The one major flaw of this book is perhaps Chapter 10, “Venous Anatomy”. Eight chapters (Chapters 2–9) covered the arterial anatomy of the head, and only one chapter was given to the important and very relevant venous system. This chapter is too compressed and extremely summarized to be described as anything but a general overview. Its true that venous anatomy of the head in itself could amount to a complete book, but in lieu of that, perhaps two separate chapters describing the veins of the brain and the veins of the posterior fossa would have been a better approach.
The Appendix includes two sections. “Appendix 1 Diameter of Vessels”, which denotes the diameter of the proximal intracranial arteries that comprise the anterior and the posterior circulation. “Appendix 2 Laboratory Drawing: Middle Cerebral Artery” consists of a basic drawing illustrating the branching pattern of the middle cerebral artery, with annotated text indicating its external caliber. The value of Appendix 2 is debatable; it is a drawing too crowded, with text that is too small, and overall, is likely to be disregarded by the reader.
This is not a multi-volume series on such a vast and complex topic as neurovascular anatomy of the head. This book is perhaps most relevant to interventional neuroradiologists, interventional neurologists, or endovascular neurosurgeons looking for a quick and easy read, and the organization of each chapter allows for just that, as chapters do have a heavy emphasis on illustrations, cadaveric dissections, in vivo dissections, and angiograms.
Unfortunately, for those wishing to further their knowledge on what is being studied, there is not a single reference on this book. Other, more comprehensive and larger texts would have to be reviewed to fill this gap.
