CT of the Head and Spine

American Journal of Neuroradiology

Norbert Hosten and Thomas Liebig. Thieme, 2002. Price, $129.00; 426 pages, 420 illustrations, 21 tables.

Although it is difficult to develop enthusiasm for a book that deals exclusively with CT scanning of the head and spine, this compendium of illustrations and brief discussions of many pathologic processes will be of some use for those who are not in the primary practice of neuroradiology. It can also serve as a review of CT of the CNS.

Drs. Hosten and Liebig have divided this 426-page book into two main sections: CT of the head and CT of the spine. The expected subdivisions for the first section include craniocerebral trauma, cerebrovascular disease, inflammatory disease, tumors, degenerative and demyeling disease, congenital brain disease, postoperative, facial skeletal, and skull base. The subdivisions for the second section include a variety of functional and structural diseases of the spinal column, intraspinal masses, and inflammatory disease. The foreword of the book indicates that a comparison of CT with MR imaging is a prominent part of the book; unfortunately, this is not the case. Although there are a few such comparisons, a comprehensive and analytic comparison is not included.

Common and unusual pathologic entities are described with the following format: pathogenesis, frequency, clinical manifestations, CT morphology, and differential diagnosis. Each disease is treated in a synopsis-type manner, which does not help to deepen one’s understanding of the abnormalities under question. However, as a brief summary, it suffices.

Surprisingly, some lesions that are discussed are not illustrated, including gliomatosis cerebri, sarcoidosis, hemangiopericytoma, colloid cyst, glomus tumor, and pineal based tumors. In addition, some areas are so skimpy that they should not have been included; for example, there is only one page on ” follow-up after tumor resection“ and illustrations are not included. In some sections, mimickers of certain lesions are illustrated, which is helpful.

The references are included in an undesirable fashion; specifically, instead of citing references at appropriate places in the text, references are listed at the end of each chapter without having been cited, making it difficult for the reader to verify specific statements. To gain an understanding of how this book is superficial in places, one can look at the chapter on degenerative and demyelinating diseases. The role of CT in the year 2002 for abnormalities in these types of diseases borders on nonexistent, but the authors show multiple sclerosis, atrophy in Alzheimer’s disease, pontocerebellar atrophy, old infarcts, and cerebral atrophy on CT scans and list references that, as one would expect, are 10 to 15 years old.

The section on CT of the spine fares no better. Showing osteomyelitis, epidural abscesses, and arachnoiditis on CT scans serves little purpose. The limitations of CT for spinal cord mass evaluation goes without saying.

Except for a quick perusal of typical CT features and a quick description of some generally well-known findings, this book serves a limited purpose. It unfortunately is a book published decades after it might have had an impact.