Decision-Making in Adult Neurology, 1st Edition

By Brett Cucchiara & Raymond S. Price 

ISBN: 9780323635837 

Pub Date: October 6, 2020 

Reviewed by: Olivia K Gruder, MD (Thomas Jefferson University)  

Description  

For each dedicated topic, the authors have provided both easy-to-follow flow charts in addition to thorough discussions alongside the charts explaining the topics in more detail. Occasionally, each chapter will provide additional illustrations or pictures. The website eBook also provides coverage of the 119 chapters with drop-down menus providing links to jump to the text, flow chart image, or any other pertinent images or videos. There are two videos for reference of pertinent topics for online viewing only. 

Purpose  

The purpose of this book is to serve as a reference for practicing physicians regarding various commonly encountered adult neurologic conditions. It is useful for initial training in medical students, in addition to being utilized as a resource for review or reference among residents and attendings. The authors stress the importance of limiting bias in medicine and the utilization of flow charts allows for thorough review; perhaps limiting anchoring, confirmation, and availability bias in patient care. This is essential to remember and carry out in patient care. The dedicated flowcharts have potential to help healthcare providers and learners minimize bias in the workplace and consider all differentials thoroughly. Having both print and online versions is helpful mostly to cater to professionals who prefer hard copy versus online reading. Although there are a few videos available for review online and the hyperlinks to resources allow for easy review, there are no other significant discrepancies between the online and print versions. 

Audience  

Students, residents, and practicing physicians can all benefit from this book. It can be utilized in reviewing a complicated topic for students, given that it provides both a broad overview and specific details in a differential diagnosis of particular topics. The book meets the needs of any general neurologist rather than subspecialty care given that it serves as more of an overview of each topic. Author Raymond S. Price, MD serves as the director of the neurology residency program at University of Pennsylvania and is also the co-director of the neurohospitalist division at Penn Medicine. His experience working with residents undoubtedly contributes to his well laid out differential diagnoses with an easy-to-read format. Author Brett L. Cucchiara, MD is a professor of neurology at the Hospital of the University of Pennsylvania and is a fellow in stroke and neurocritical care. His expertise in high-acuity care neurology is reflected in many of his chapters, namely on transient ischemic attack (TIA) and delirium. 

Features  

Frequently encountered neurologic syndromes are individually discussed in an algorithmic and concise manner. The chapters are split into two parts: one on signs and symptoms and the other on specific neurologic conditions. Within these two halves are specific sections with a vast array of topics. They range from etiologies for acute spontaneous intracerebral hemorrhage to management of comorbidities in patients with epilepsy. The text is on the left page followed by a flow chart on the right page. Both acute and chronic neurology topics are well represented. Occasionally, supplemental image findings including MRIs and CTs are interspersed throughout the chapters. The topics are followed by appendixes 1 and 2 and an index. Appendix 1 contains additional tables for referencing, e.g., medications commonly used for delirium. Appendix 2 contains scales such as the NIH stroke scale and pictures to utilize during a stroke alert to assess for neglect, aphasia, and dysarthria. The index contains numerous neurologic conditions in alphabetical order, including those that are not specifically outlined with their own specific page providing a reference for a similar condition. 

Assessment  

I have yet to encounter a resource with such a concise yet thorough approach to neurological decision making. As a medical student, I utilized Pocket Neurology, 2nd edition, Westover (Wolters Kluwer, 2017), which I personally found overwhelming when first approaching the material, especially as there were limited to no flow charts. I never made it through reading the entire guide, whereas I see myself being able to read each topic or at least reviewing the flowcharts in the book under review. As a neurology resident, I am thrilled to have found this book. I will personally utilize it for reference throughout residency and beyond and I will also recommend it to medical students. Regardless of training level, I view this contribution to neurology literature as substantial and much needed. 

©Doody’s Review Service, 2021, Olivia K Gruder, MD (Thomas Jefferson University) 
Doody’s Score: 94 – 4 Stars!  

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