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Neurosurgical Aspects of Pregnancy

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    Neurosurgical Aspects of Pregnancy.Neurological Topics Series. Edited by c loftus. (Pp 255.) Published by the American Association of Neurological Surgeons, Park Ridge, ILL. 1996. ISBN 1-879284-36-7.

    Pregnancy is a condition encountered infrequently in neurosurgical practice and yet it complicates many facets of patient management, including investigation, drug therapy, anaesthesia, and surgery. As such, clinicians may be unfamiliar with the most appropriate way to manage the condition, nor able to counsel the patient fully as to the precise risk both to the foetus and herself. Although this information is available in the literature it is not readily accessible, particularly in an emergency setting. This book is designed to fill that void by distilling the necessary information into a single slim volume.

    This text has been produced by the American Association of Neurological Surgeons as part of its Neurosurgical Topics series. It follows the familiar pattern of a review of the literature which is concluded by a short series of multiple choice questions intended as revision for trainees. The book is divided into three parts. The first is a general section which is equally applicable to various disciplines, not just to neurosurgery. It includes the potential foetal toxicity of commonly used drugs, the risks associated with diagnostic imaging and with anaesthesia, haemostatic and thrombotic considerations, and the physiological changes to cardiovascular and cerebrovascular function that occur during pregnancy. The second section covers specific neurosurgical disorders such as back pain, carpal tunnel syndrome, pituitary tumours, subarachnoid haemorrhage, venous thrombosis, benign intracranial hypertension, hydrocephalus, and ventriculoperitoneal shunt management. The final part discusses patient positioning and foetal monitoring for surgery, the intrauterine diagnosis of developmental disorders, the current status of intrauterine surgery, and ethical issues surrounding the management of brainstem death and the permanent vegetative state.

    This is a truly excellent volume. All that could be reasonably expected to be covered in a book on this subject is here. The chapters are clear, concise, and have been referenced extensively for further reading. Every practising neurosurgeon should have ready access to this work.