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Prevention of Ischemic Stroke.

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    Prevention of Ischemic Stroke. Edited by cesare fieschiand mare fisher (Pp 304, £65.00). Published by Martin Dunitz Publishers, London, 1999. ISBN 1-85317-738-5.

    This is a multiauthor reference book with contributions from epidemiologists, neuroradiologists, neurologists, and cardiologists. It succeeds in being both comprehensive and concise, making it a valuable book to have available to “dip into“. However, it is quite a long haul to read from start to finish.

    There are chapters of practical use to physicians, both community and hospital based, who are involved in vascular risk factor management and specifically the primary and secondary prevention of stroke. For example, the chapter on “when to anticoagulate and at what dose“ is particularly useful. Topics such as lipid lowering, antiplatelet strategies, and the management of carotid disease are covered well with pragmatic advice based on the available evidence. Where there are gaps in the evidence is also clearly stated.

    There is a helpful section on haematological disorders and stroke risk with detailed information on the congenital and acquired thrombophilias and advice on routine screening for these problems. A chapter devoted to the aetiology of “young stroke“ is particularly welcome. At the cellular level there is a fascinating review chapter of the molecular mechanisms affecting the development of symptomatic carotid plaques—obviously fertile ground for further research.

    Contained within each chapter are helpful tables usually summarising results from available randomised controlled trials and there are some clear schematic diagrams to illustrate relevant pathophysiological and. biochemical pathways. In summary this book would be an excellent addition to any hospital or community service involved in this very important subject. It will be of value to general practitioners, physicians, cardiologists, neurologists, and trainees.