Brain, Vol. 123, No. 11, 2364-2365,
November 2000
© 2000 Oxford University Press
Book reviews |
CENTRAL NERVOUS SYSTEM ANGIITIS.
By James W. Schmidley. 2000. Oxford: Butterworth Heinemann. Price £70. Pp. 240. ISBN 0-7506-7153-X.
Department of Neurology, Frenchay Hospital, Bristol, UK
This book carries the air of a labour of love. I warmed to it from the moment I read the first paragraph. It is such an unexpected pleasure to meet (in print, anway) someone who shares the same irritants—the `widespread (and it's the same this side of the Atlantic too, I regret to say, Dr Schmidley), groundless belief' in the value of lupus vasculitis as a common pathological substrate for CNS systemic lupus erythematosus, and in angiography as a useful diagnostic test for vasculitis.
The author's deceptively conversational style is a pleasure to read, and it is both refreshing and reassuring that there are still experts who wear lightly their authority and clinical wisdom, and who are prepared, for example, to mention disarmingly that their text `lacks the space, and its author the inclination or talent [to deal in excessive detail with the immunology of vasculitis]'—which is then, of course, dealt with briefly but informatively and cogently. The book takes the form of an excellent series of reviews, covering most aspects of vasculitis in relation to the central nervous system. Thus, almost all the first half of the text is dedicated to the clinical features, diagnosis and treatment of isolated CNS angiitis, including the slightly vexatious issue of so-called `benign' angiitis, or more accurately, angiographically diagnosed angiopathy. The second half covers secondary vasculitis, with chapters dealing with angiitis in the context of malignancies, systemic inflammatory diseases, toxins and drugs of abuse, Behciet's disease, and (some) infections. All are authoritatively described in what rapidly becomes a familiar and easy style, invariably comprising an accurate and critical review of the literature, rendered the more palatable and valuable by the author's own thoughtful experience.
Are there faults? It is, as the reader will have gathered, a rather personal perspective, and the very clear advantages of consistency of style and intellectual approach do not always outweigh the exclusion of alternative views. It might fairly easily have been a little more contemporary—of the near 600 references, only a very small handful post-date 1995 [although the author might (worryingly) point out that not much really has happened in the last 5 years to justify inclusion].
I liked this book very much. It could be read or just referred to, but mostly simply enjoyed, by neurologists specializing in vascular disease or managing sick but potentially treatable patients—in other words, by neurologists actively interested in neurology.
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