Castillo M. Neuroradiology Companion:  Methods, Guidelines, and Imaging Fundamentals.  Wolters Kluwer Health | Lippincott Williams & Wilkins 2011, 624 pages, $89.95.

The 4^th edition of Dr. Castillo’s highly successful Neuroradiology Companion: Methods, Guidelines, and Imaging Fundamentals is now available. It contains basic information which should be known by every trainee, whether fellow or resident. It provides a reasonable summary of major diseases that can be reviewed by all those involved in the interpretation of neuroimaging studies.

This softcover, 605-page book is 178 pages longer than its predecessor and contains a number of new features. It is divided into 2 major sections the first of which is entitled “Imaging Protocols and Guidelines” and contains specifics on CT, MR, myelographic, and DSA protocols—each with its own CPT code. There is valuable material on sedation, management of contrast reactions and other medications used in radiology, and a series of sample (templates/macros) dictations recommended for all commonly performed procedures. The second section involves the description and major points involved in over 260 different diseases. This represents an increase over and above the material present in 3^rd edition (2005): in the brain (85 more pages), spine (18 more pages) and head and neck (33 more pages). There are many new areas and subjects described, such as craniostenosis, increased cases on brachial plexus abnormalities, and a section of color imaging which primarily enables one to evaluate CT and MR perfusion maps, PET, and CTA/MRA. These are just 3 examples where there has been an increase in material. Along with more cases we see the inclusion of infrequently used terms such as hematohygroma, and the inclusion of more diffusion weighted imaging.

The reading of this companion is made straightforward and easy by the inclusion key facts for every case. This is information everyone training in neuroradiology or actively practicing neuroradiology should know. There are, at the conclusion of each case, one or two citations for suggested readings. A  good exercise is to look at each case, think of 6 or 7 of your own key points (i.e. what you would list), and then read what Dr. Castillo has considered as his key points.

Dr. Castillo has added a 10-page section entitled “Sample Dictations,” which are his recommendations of approximately 40 common, normal dictations in neuroimaging. These are what could be called standardized reports, which are different from the evolution toward the structure or itemized reports that are now becoming increasingly popular with the use of voice recognition.

Just as in life, as “companions” age they tend to get larger. Such is the situation with this new edition. When a 5^th edition appears, which will certainly occur, one would hope that a slimmer companion would be the result. That could easily happen even if new material is added, because the current edition has an abundant amount of wasted space:  there are some pages where 50-90% of the page is blank (this reviewer doubts this huge amount of space would be used to write notes as Dr. Castillo suggests in his preface). These pages could be subject to a weight reduction diet, and we’d end up with a svelte companion. A very positive by-product of this could be a book which would neatly fit into one’s lab coat (which is not possible now).  Then you’d have a real companion.

This is a highly recommended text; in fact, it is one which should be on a required list for all housestaff. They might even stump their attendings by remembering some of the many pearls which Dr. Castillo has given us.