Stroke.

Stroke Stroke was written by three neurologists as a guide to help physicians in their diagnoses and treatment of any disorder involving cerebral circulation. There are 36 chapters, covering neuroanatomy, pathology, evaluation, and current therapy for the "most common, serious neurological condition. At the end of each chapter is an extensive list of references. Illustrations and tables are numerous and aid in understanding the text.

The chapter pertaining to risk factors of stroke contains much useful information. The number one risk factor is a history of transient ischemic attack. Obesity, although a weak risk factor by itself, is a major one when combined with hypertension. The references are current.

The chapter on transient ischemic attacks provides a clear explanation of differential diagnosis and outlines the physical examination and tests indicated. Medical treatments for cardiac problems and hypertension and procedures for administering anticoagulants are described. The section on surgical treatment includes a discussion of patient selection and complications of a carotid endarterectomy.

Rehabilitation from stroke is covered in a brief chapter that is unevenly written. This chapter details an effective program including all aspects of patient care, from preventing pressure sores to evaluating cognitive ability. The author, however, states that patients experience improved motor function because of increased use of the uninvolved side. Use of a sling to help a painful paretic arm is mentioned, but the type of sling is not specified. On the other hand, use of electrical stimulation is commented on as a possible beneficial treatment in avoiding a shoulder-hand syndrome.

The last third of the book addresses special problems such as stroke in children, migraine headaches, and the use of oral contraceptives. The section concerning treatment of hypertension deals with drug therapy and nonpharmacological methods (weight reduction, diet, and appropriate exercise programs).

Although written for physicians, I believe Stroke would be a useful resource to have available to physical therapy practitioners, especially in a hospital or rehabilitation setting. The summaries and tables are informative, and the text will aid in understanding the pathology and medical treatment of patients recovering from stroke.