BOOK REVIEWS

Book Review: Stroke Revisited: Hemorrhagic Stroke

By: Seung-Hoon Lee, editor
Published by: Springer International Publishing, AG,

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Cham, Switzerland 2018
Hardcover: 439 pp.
Price: $149.99
ISBN: 978-981-10-1426-0

Hemorrhagic stroke is an increasingly common emergent

neurologic presentation. The heterogeneity in management of
the disparate forms of this disease requires a fundamental under-
standing of the varying pathophysiology and mechanisms under-
lying it. This is essential for optimizing patient care and treatment
paradigms, particularly when pursued in the context of the
latest in basic science and clinical trials research. Stroke Revisited:
Hemorrhagic Stroke proves an effective resource to fulfill this
need, providing a concise yet thorough reference for foundational
understanding of hemorrhagic stroke.
The book is divided into 2 major sections: background and
clinical practice. Part I provides general information on various
forms of hemorrhagic stroke; intraparenchymal hemorrhage,
subarachnoid hemorrhage, arteriovenous malformations, and
Moyamoya disease. This is intended as support for Part II, which
focuses on the diagnosis, medical, surgical, and endovascular
treatment options, as well as finally long-term care and prognosis.
Each chapter is well-researched, making specific reference to
basic science and clinical trial data. While broad in content,
the text remains succinct and approachable, and is accompanied
by numerous high-quality figures, particularly in the sections
pertaining to clinical diagnosis. This makes this work a useful
reference for those encountering these patients in their practice.
It should be noted that the writing does occasionally suffer from many ways this will make the work more readily approachable to
language errors. These should not detract from the quality of the the clinical practitioner.
work as a whole. “Part II: Diagnosis and Treatment of Hemorrhagic Stroke”
“Part I: General Facts on Hemorrhagic Stroke” provides a then applies these foundational mechanisms to the care and
mechanistic understanding of the pathophysiologic mechanisms management of these patient populations. The initial presen-
underlying hemorrhagic stroke. It begins with an effort at reclas- tation, differential diagnosis, and decision-making pathways are
sifying hemorrhagic stroke from the established categories— well described, oftentimes in graphic algorithms. Attention is
primary and secondary—to a more pathophysiologic system— paid to the major principles of management—such as reversal
arteriosclerosis-related, cerebral amyloid angiopathy-related, and of anticoagulation, blood pressure goals, complications such
internal cerebral hemorrhages resulting from other specific causes. as seizures and hydrocephalus, and the role of therapeutic
This is a laudable effort to move toward a mechanistic under- interventions—as guided by major clinical trial data, firmly
standing of hemorrhagic stroke; unfortunately this classification basing recommendations in evidence-based medicine. These
system is not well-maintained throughout the rest of the work, sections make excellent use of imaging correlates as well, again
making its inclusion a bit of a non-sequitor. Despite this, this providing ease of reference. Beyond the initial presentation and
section makes good on the examination of risk factors, incidence, emergency care, a broad understanding of medical therapy in the
and pathophysiologic mechanisms. The authors do an excellent intensive care unit (ICU) setting is also described, as well as the
job of detailing extensive basic science efforts. The succinctness strengths and weaknesses of surgical interventions, endovascular
of these reviews occasionally comes off as a bit cursory, but in options—particularly as it relates to aneurysmal subarachnoid

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BOOK REVIEWS

hemorrhage and arteriovenous malformations—and long-term
prognosis and rehabilitation. This is not a nuanced description
of the clipping of aneurysms, nor is it intended to be. Instead,
this work provides a foundational understanding of the essen-
tials of managing these patients from arrival to discharge, thus
providing excellent context for those involved in their care during
patient’s suffering from hemorrhagic stroke, from initial presen-
tation to long-term rehabilitation.
Disclosures
The authors have no personal, financial, or institutional interest in any of the
drugs, materials, or devices described in this article.

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their clinical course.
Stroke Revisited: Hemorrhagic Stroke provides a foundational C. Michael Cawley, MD
understanding of the pathophysiology, care, and management of Nealen Laxpati, MD, PhD
hemorrhagic stroke. It is thus best suited to the neurologist or Emory University School of Medicine
neurosurgeon in training, as well as emergency and rehabilitation Atlanta, Georgia
physicians, nursing staff, and ICU support personnel involved in
the care of these patients. It will prove to be a welcome resource in 10.1093/neuros/nyz467
those seeking basic understanding of the care and management of

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