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The cranio-cervical syndrome: mechanisms, assessment and treatment.
  1. J Van Dellen

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    By Howard Vernon (Pp 262, £39.99). Published by Butterworth-Heinenmann, Oxford, 2001. ISBN 0 7506 4495 8

    An unusual book, multiauthored and multidisciplinary, which despite the title deals largely with pain in general, and to an extent “whiplash injuries”. The chapters contain wide ranging references and significant review material. The text often raises more questions than answers. A major drawback is that the chapters are not confluent and seem to be isolated contributions (some chapters clearly state that the content is modification of a previous publication or presentation). The scientific content of the chapters varies widely and in isolated chapters there are strong subjective views, not convincingly underpinned by scientific observations. There is excessive anatomical and physiological information on recognition, processing, and pathophysiology of pain. At the end of some chapters there is a brief paragraph or item relating to the book title. The chapter on diagnostic imaging provides visual material, but standard radiography dominates over modern imaging modalities such as MRI and CT. The chapter on biomechanics of the upper cervical spine concentrates largely on the relations between the atlas and the occipital condyle. A chapter on tension-type and cervicogenic headaches provides a review, including past trials, but little new information, which also applies to the chapter on the medical management of the craniocervical pain. The contribution on the psychological aspects of head and neck pain, by contrast, is far more comprehensive and useful. The chapter on whiplash injuries and the upper cervical spine again provides basic information, many references, but few practical suggestions. Manual therapy on children provides a highly personalised view of a treatment modality. Finally, the chapter on cervicogenic vertigo is practical and succinct, by contrast with the last chapter on vertebral basilar incidents which provides little new.

    The book would be a useful acquisition for a library and provides useful references and comments for health practitioners dealing with patients with, or involved in litigation related to, injuries in the craniocervical area.

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