Abstract
As the editors point out in the prefaces to both the first and second editions of this book, ‘clinical cases … represent the best way for physicians to learn clinical medicine and convey knowledge among peers’. They further state that ‘cased-based learning has become a major educational offering at all levels of medical education and in particular the headache field worldwide’. The editors finish the Preface with the hope that the cases in the book will help patients with headache under the care of the reader. What follows embraces the credo of case-based learning. The book is comprised of 58 cases which have been contributed by authors who are from many countries, which provides an international flavour to the text. Each chapter is organized according to the following structure. First, the case history (or occasionally more than one case history) is presented and then some questions are posed to the reader about the case followed by a case discussion. What follows next is typically an overview of the topic with discussion of diagnostic and management issues. A list of selected reading is provided and, finally, an editorial comment followed by the diagnosis concludes each section. Obviously with this format, each case provides its own independent packet of information for the reader, making it convenient to read through the text leisurely with nothing lost even if the book is set aside for a time. A broad array of cases is covered ranging from common disorders such as migraine (including several subtypes and complications) to rare but distinct primary headache disorders such as SUNCT. Secondary headache disorders are not neglected; a broad array of cases including subarachnoid haemorrhage, low cerebrospinal fluid pressure headaches and arterial dissection are included—to name but a few. A useful diagnostic table of contents lists each chapter with the diagnosis, easily providing the reader with the option to read about selected topics. For those who prefer to see the text and illustrations on a computer screen, a CD-ROM is provided.
The large number of diverse contributors is a strength of the book. It provides a heterogeneous, international viewpoint to a variety of topics as well as different writing styles. On the other hand, the large number of authors can lead to points of view which differ from the generally accepted principles of evidence-based medicine. Fortunately, these deviations from standard care or controversial points are usually discussed by the editors at the end of each chapter. Nevertheless, there are, as one would expect, some statements which might be challenged. For example, Chapter 26 has the statement that otoscopy and rhinoscopy should be incorporated into the examination of every patient with headache, which is not universally accepted. Another is the recommendation made in Chapter 15 asserting that bedside spirometry should be done in subarachnoid haemorrhage—a procedure which might be expected to increase the risk of rebleeding. On the whole, though, such issues are infrequent. I would suggest that in the next edition the selected reading list be made into a list of references which refer specifically to the text, allowing the user more easily to find the support for assertions made.
In conclusion, this book fulfils the goals outlined by the editors in the Preface and I recommend this book to physicians, both headache experts and neophytes, who are interested in learning more about headache disorders. Their patients should be the beneficiaries of what they learn.