Tisnado J, Ivatury RR. Interventional Radiology in Trauma Management. Thieme; 2015; 378 pp; 662 ill; $149.99
Interventional radiology has assumed a major role in the care of patients seen in a trauma center. Because of this, such a book focused on the role of IR in trauma is valuable.
First, this book briefly reviews the ever-changing principles of trauma resuscitation and periprocedural management. While this may seem out of place in a radiology book, the interventionist performing these procedures often does not have an anesthesiologist present and needs to know these principles. Incorrectly being overly aggressive with fluids in resuscitation or not being cognizant of the dangers of hypothermia in trauma can have devastating consequences and negate any well-performed intervention. Then, the book focuses on imaging of trauma patients, with chapters on thoracic trauma imaging, abdominal trauma imaging, and peripheral vascular trauma imaging. Following these, there is a chapter bearing the title “The Role of Nuclear Medicine Imaging in Trauma”. When this reviewer went to this chapter, I fully expected one word to be present: “NONE”. But the authors do explain that nuclear medicine is used to verify brain death and can be used to problem-solve CSF leaks and some cases of bile leaks after liver laceration. Notably missing is a chapter on just diagnostic imaging in neurotrauma.
After these introductory chapters, two chapters are dedicated to interventional radiology in neuro trauma. The first is on neck trauma. While well-written, no angiograms or cases are shown. A chapter on interventional radiology in head trauma follows. While this chapter restates some topics of the preceding chapter, such as the three zones of penetrating neck injury, it does then move on to neurointerventional radiology’s role in head trauma, including beautiful examples of traumatic intracranial aneurysms as well as a detailed section on traumatic carotid-cavernous sinus fistulas.
This book is not recommended for a dedicated a neuroradiologist. This book is obviously targeted to an interventional radiologist, a trainee, or a radiologist already in practice. It is well-written and well-illustrated. Additionally, it is the only book dedicated to this important topic. For that reason, I recommend it to any interventionist who wants to learn or review trauma in such cases. It would also be valuable for a diagnostic radiologist who works in the emergency department of busy trauma center. By knowing what interventional radiology can and can’t do, the diagnostic ED radiologist could go beyond just interpreting images and generating reports and help the trauma surgeon and ED staff decide if interventional radiology can help treat the patient.
