The editor of this recently published book is Chief and Professor of Neurology at Amiens, a city dominated by its splendid gothic cathedral. He has enlisted the help of over 50 colleagues to produce a detailed reference text, which will be of help to psychiatrists and geriatricians, as well as neurologists. Allied health and nursing staff who work with stroke patients will find it useful for looking things up too, though I doubt if many people will read the whole thing from cover to cover. If in the end it resembles more a series of gargoyles than a complete ecclesiastical building, like most collections of gargoyles it has several fascinating elements.

Putting architectural analogies aside, there is a decidedly European flavor to this book. The largest number of chapter authors comes from France and most of the rest work in other countries of continental Europe, which means that the Americocentricity of so many medical textbooks is avoided, but despite the fact that English is not the first language for over half of the chapter authors, I found nearly all the chapters to be written in clear fluent English with fewer grammatical infelicities than I find in the essays of my Australian educated psychiatry trainees. Either the book has been superbly edited by CUP staff or, more likely, the tendency of so many European specialists to work at some point in North America or Britain is these days being reflected in the excellent quality of their written English.

There are 32 chapters organized into three parts (Vascular cognitive impairment, Analytic approach: the cognitive and behavioral neurology of stroke, and Dementia and management of management of vascular cognitive impairment), but the 26 chapters of Part 2 constitute the vast bulk of the book and are further divided into six subsidiary sections. Psychiatrists may feel that limiting consideration of behavioral and mood disorders to 75 pages out of 422 is rather to short change the reader, and I would have liked to have seen a chapter on disinhibition and aggression after stroke included (there is but one reference to aggressive behavior in the index, which leads one to a single paragraph describing phenomena, which is utterly devoid of advice on management), but scholarly chapters on such subjects as acalculia, asomatognosia, and cortical blindness offer the chance quickly to learn quite a lot about some of the protean clinical manifestations of cerebrovascular disease.

You won't find out here how to help a relative whose husband has started to belt the living daylights out of her after his stroke, or how to counsel a couple seeking advice on the resumption of sexual intimacy after one of them has experienced a cerebral infarct, and the lack of any chapter on carers of stroke patients is a massive and regrettable omission, but I learned a considerable amount from perusing this text and any university or hospital library ought to have a copy. For about the same price one could buy two good stalls seats to King Lear at London's National Theatre, four complete sets of the Beethoven piano sonatas by Arrau, Barenboim, Brendel, and Kempff from Amazon, or a discounted Eurostar return from London to Paris and still have £30 to spend on a return ticket to Amiens or a bottle of champagne when you got there. So is it good value for money? Perhaps these comparisons are invidious and it is better to say that I could earn enough to buy this book by reviewing a private patient in Melbourne for 30 minutes, and if she had experienced a stroke recently, it is likely that she and her family would get better value from my input if owned the book under review than if I did not.