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|Year : 2017 | Volume
| Issue : 5 | Page : 1205
Practical Neurosurgery: Analysis of clinical cases
Department of Neurosurgery, Chettinad Hospital and Research Institute, Chettinad Academy of Research & Education, Kelambakkam, Chennai - 603103, Tamilnadu, India
|Date of Web Publication||6-Sep-2017|
V G Ramesh
Department of Neurosurgery, Chettinad Hospital and Research Institute, Chettinad Academy of Research & Education, Kelambakkam, Chennai - 603103, Tamilnadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ramesh V G. Practical Neurosurgery: Analysis of clinical cases. Neurol India 2017;65:1205
Author : Sanjay Behari, Chandrashekhar E. Deopujari, Natarajan Muthukumar, Vedantam Rajshekhar
Publisher : Thieme Publishers
Edition : First
Year : 2017
Number of pages : 528
Illustrations : 166
Most of the neurological and neurosurgical disorders have distinct symptomatology and require a methodical approach, including a detailed history taking, meticulous clinical examination, symptom analysis, correlation with the clinical findings, appropriate imaging and other investigations to arrive at a precise diagnosis and for planning appropriate treatment strategy. Unfortunately, this methodical clinical approach is gradually declining, with more and more reliance being placed on investigations, especially imaging. Even in this era of advanced imaging technology, clinical medicine has a lot of relevance: (1) The clinician has to decipher the actual suffering of the patient and plan the treatment to alleviate this suffering and this is possible only on the basis of history and examination findings. (2) Appropriate investigations, especially imaging of the appropriate area, can be planned only on the basis of clinical diagnosis. (3) The clinician has to determine whether or not the patient's clinical problem and imaging correlate and if surgery will alleviate the patient's symptoms. (4) During the postoperative follow-up also, one can decide whether or not the patient has improved, worsened or is static, only on the basis of symptoms and clinical examination. But pathetically, the present day neurosurgery textbooks deal mostly with the investigation and surgical techniques and less with the clinical aspects of the disease. The book in focus is an effort in the above-mentioned direction. This is an attempt at symptom-based approach to the clinical diagnosis of neurosurgical problems. The Neurological Society of India and the editorial team of Drs. V. Rajshekhar, C.E. Deopujari, N. Muthukumar and Sanjay Behari have to be commended for their dedication and effort in bringing out this book.
All the chapters have been authored by senior neurosurgeons and neurologists of the country with expertise in the concerned fields and this is also reflected in the quality of the content. Illustrative diagrams, photographs, flow charts and tables have been used liberally which has added value to this publication. Common symptoms of presentation in neurosurgical problems have been chosen as topics. Each chapter deals with a step-wise approach to one of these symptoms to arrive at a precise clinical diagnosis, and based upon this, to order relevant investigations to establish the diagnosis. In some chapters, a brief outline of management also has been added. The simplicity of the chapters makes reading them a very pleasant experience and will be appreciated by all.
Though most of the chapters have conformed to the symptom-based approach to the clinical diagnosis and investigations, there is some lack of uniformity in the presentation. In some of the chapters, there has been more emphasis on the investigative and radiology-based diagnosis. Some of the chapters mimic a ‘textbook of neurosurgery’ approach, elaborating the pathological classification of tumors, description of individual types of tumors, description of surgical procedures, etc., which do not form the aim or scope of this book. Also, the topics could have been arranged in a more orderly fashion in the form of higher mental function, cranial nerve examination, and motor, sensory and autonomic symptoms.
The symptom-based approach with emphasis on the history and clinical examination of the patient is a long-felt need and this book has attempted to resurrect this forgotten art. This book will be a boon for not only the trainee neurosurgeons facing the exit examination, but also the medical practitioners and internists. It also serves the purpose of a ready-reckoner for the practicing neurosurgeons, as well. Overall Practical Neurosurgery has initiated a new and distinct trend in neurosurgical publications which will serve the day-to-day needs of neurosurgeons in training and in clinical practice.