This volume is ambitious in scope and novel in format. The idea was to provide succinct chapters on a comprehensive list of topics related to the management of traumatic brain injury (TBI) in a “pocket-sized and portable” book. Each chapter would provide the essential nuggets in a few pages, and refer the interested reader to seminal articles, longer textbook chapters, and websites for more depth on each topic. The chapters are organized in quasi-sequential fashion, from acute management issues to those more relevant to long-term outcomes. After initial sections on core concepts and epidemiology, including material related to TBI pathophysiology and severity classification, there are separate sections on mild TBI (mTBI) and moderate/severe injury. The volume concludes with a section on medical complications (e.g., seizures, headache) and a “special considerations” section covering diverse topics such as alcohol misuse, ethics, TBI in children and the elderly, and blast injury. In a nod to the consumer perspective, the final chapter was written by a young woman with severe TBI and tells the story of her and her mother's dogged search for alternative treatments after she was advised by medical professionals that no further recovery was possible.
Does this handbook succeed in its stated aims? To some extent, yes. Each of the 69 chapters is indeed just a few pages long, and many consist exclusively of bulleted lists and tables. Most are clearly organized, with bolded headings separating every few paragraphs. This makes for a very readable format, one in which it is impossible to get bogged down in detail. The Preface notes that physicians and medical trainees comprise the primary audience, but suggests that clinicians in allied disciplines should also find the book useful as a resource. Medically oriented topics do dominate the volume, with longer term issues relegated to the “special considerations” section. For this reason, neuropsychologists involved in TBI management on the acute care or acute rehabilitation unit are much more likely to find the book useful than those engaged in assessment or rehabilitation on the post-acute side. Succinct, encyclopedia-style entries on cranial nerve palsies, endocrine dysfunction, autonomic instability, and other medical sequelae provide basic guidance on how such early complications affect the function and care of patients with TBI, and could easily help non-medical professionals to educate not only themselves, but also patients and families about the causes, consequences, and terminology associated with these disorders. In contrast, this book is not a particularly good resource to use for learning more about how to help people live with the long-term consequences of TBI. There is one brief chapter on return to work and another on community integration, but little to no content on the impact on the family; friendships and social isolation; or recreation and exercise, all “hot topics” for the professional struggling to assist the person with TBI who is struggling in turn with significant changes in community activities and life roles. And it is startling to read (in a thin chapter on cognitive impairment) that “treatments that have not undergone randomized clinical trials should be recommended sparingly, if at all.” So much for the vast majority of treatments used daily in the rehabilitation of people with acquired brain injury.
As in any edited volume, there is some inconsistency in quality and usefulness across the individual entries. Some of the chapter authors are recognized experts on their topics, lending confidence that the bullets they have selected to capture the complexity of a given facet of TBI management are the ones you will need in a quick review. As one example, John Corrigan's piece on alcohol misuse packs an amazing amount of immediately useful “how-to” information into just 5 pages. Other chapters, particularly the 15 covering mTBI, are harder to use as stand-alone resources; for example, separate chapters discuss somatic and cognitive symptoms, and there is also a somewhat awkward separation between symptom identification and symptom management in the different entries. Presumably this was intended to allow each author to limit his or her material, but for the reader it means that consulting multiple chapters is needed to gain a reasonably useful perspective on mTBI.
Within the essentially medical framework of the volume, the references provided at the end of each chapter are useful, consisting as they do of journal articles, textbook chapters, and web references. Regarding the last, which are ephemeral by nature, it might have been a better idea to consolidate the web citations into a separate section listing comprehensive and long-standing websites that could be searched for more information on selected topics; a quick perusal of the URLs included at the end of each chapter revealed several that are already inactive.
A final quibble: tipping the scales at nearly 1-1/2 pounds, this book is hardly “pocket-sized.” However, it may find a place on your reference shelf if you need a handy guide to the medical issues that accompany TBI.