ADF Health April 2001 - Volume 2 Number 1Book reviewNeurosurgery in the tropics
MANY WHO PRACTISE MEDICINE outside major centres are confronted with inescapable patient management decisions with potential neurological consequences. Not all neurosurgery can be conducted by full-time neurosurgeons. This new book is a practical guide for doctors operating outside centres with a practising neurosurgeon, written by authors with extensive experience under difficult circumstances in Australia, Papua New Guinea, Zimbabwe, Zambia and other developing countries. It is a splendid, clearly written diagnostic guide for those in the field. It covers the crucial questions of clinical assessment in the potential neurosurgical context, and will be an aid for those who have to decide on aeromedical evacuations, summoning of trauma teams or (most difficult of all) when not to operate. The book describes details of common neurosurgical operations, particularly emergency operations to preserve life or brain function, in the clearest terms. There are excellent sections on head injury in the context of developing countries, congenital malformations involving the craneospinal axis, diagnosis of brain death, neurorehabilitation and medicolegal issues. I commend the book to all who work in tropical settings, refugee camps, or in outback or other isolated medical practices, and to all those doctors who may go on operational deployments with the Defence Health Service. Major General John Pearn, AM, RFD (Rtd)
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