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This book’s reputation preceeded its arrival on my desk with the news that Boston Spa already had a six month waiting list before it was on general release. What did one expect? My dictionary says a primer is an elementary reading book for children, a short introductory book. This hardly prepared one for the 6lb 2oz, 822 page encyclopaedia boasting 195 chapters written by 275 authors.
Its philosophy is admirable offering basic science for the clinician, and a clinical account for the basic scientist. The editorial guidelines should perhaps have been more rigorous, as some contributions have offered brief albeit expert overviews whilst others have produced a manuscript that would have graced a plenary lecture at a specialist conference. Section editors should have offered brief orientating introductions. The same topic appears in more than one “chapter” a duplication that somehow does not illuminate the subject in the way that it does when a debate is formally set up. There are gems, however, and nowhere else can one read about blood flow, the blood brain barrier, acidosis, excitotoxins, calcium, free radicals, and nitric oxide, etc, alongside cardiac embolism, aneurysm surgery, thrombolysis, the dose of aspirin, and rehabilitation etc. The list of contributors is a who’s who of mostly North American experts. Some will claim that there are better texts in which to look up evidence based advice on management, or the latest animal model experiments, but the insistence that the two aspects of cerebrovascular disease belong together deserves to make this volume a success despite its cost. This whole area is at last moving rapidly so read it soon or wait for the next edition!
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