Many neuropsychologists are confronted with primary and subsequent effects of a cerebrovascular accident (CVA), but the causes, symptoms, and consequences are complex and broad. This book is an ambitious attempt to provide a reference for transient ischemic attack (TIA) and stroke in fewer than 400 pages. The volume’s strength is that it is concise, but it does not cover neurological syndromes or neuropsychological manifestations. In six sections, the authors provide historical perspective, advantages and disadvantages in the definitions of TIA and stroke, and comparisons of investigational and treatment techniques. Diagnostic, epidemiologic, and treatment issues are discussed, but because such a broad range of complex factors is described, many topics are brief. For example, the authors cover 13 types of cardioembolism in approximately four pages (one of these being a Table).

Section 1 begins with background and fundamental knowledge about TIA and stroke. While the authors acknowledge associated nosological difficulties, they generally discuss TIA and stroke separately in subsequent chapters. The authors largely use United Kingdom based studies (e.g., Oxford Vascular Study, the Framingham study, and others) to identify base rate estimates throughout the text. Risk factors, such as socioeconomics, ethnicity/race, lifestyle, and other factors are identified. A general style of defining key concepts appears throughout the book, and in this section the authors attentively describe and define mortality, incidence, prevalence, and time trends as they relate to TIA and stroke. Although there is an extensive list of possible causes, each disorder is briefly mentioned; however, each disorder is worthy of a book of its own. Chapter 3 on genetics may be a welcome addition for neuropsychologists but the limited information leaves the reader wanting even further discussion. The more thorough Chapter 4 on anatomy and physiology is a strong reference, in which vascular anatomy and distribution is well-described. Even for a non-neuropsychologist, the book would be stronger if the authors had integrated the anatomy with neurobehavioral consequences.

After providing the anatomy, causes, and pathophysiology of TIA and stroke, the authors turn to clinical considerations in Section 2. They first cover various research criteria and other clinical features of CVA. Given that the two chapters covering clinical features, diagnoses, and investigation of TIA and stroke are approximately 28 pages, the authors provide a brief overview of this content. At times the descriptions are somewhat simplified and incomplete, and the chapters do not reveal the complex differentials nor localization or functional neuroanatomy. TIA and stroke assessment then continue in Chapters 10–13 with brain, vascular, and non-radiological imaging techniques addressed. These chapters provide a respectable primer on computed tomography (CT) and magnetic resonance imaging (MRI), and MRI modalities, including different MRI sequences (e.g., T1, T2, gradient echo, diffusion weighted, and perfusion) in addition to the pros and cons of each modality. Vascular imaging exemplars of magnetic resonance angiography (MRA) and catheter angiography are provided, which may be a useful reference.

The book then makes a major shift from the science of vascular events to the science of outcome in Section 3, where the authors address the prognosis of transient ischemic attack and stroke. Like the imaging tutorial in the preceding chapters, the authors provide a lesson about basics of prognosis and how it is measured. Methods for measuring risk are reviewed in addition to examples of how to predict outcomes. Short- and long-term prognosis and predictive modeling outcomes are addressed for TIA and stroke using such investigational techniques as cerebral and vascular imaging.

Section 4 introduces the reader to treatment of TIA and stroke by first describing methods of assessing treatment. The authors discuss issues of assessing clinical trials (including randomization, statistical power, and trial endpoints). These two chapters will likely not provide new information to seasoned neuropsychologists. General principles of prevention strategies as well as medications to reduce risk factors (e.g., smoking, cholesterol, cardiac) are reviewed. In the final part of this section, approximately 5 pages, the authors review recovery and rehabilitation after stroke including prognosis using imaging and rehabilitation outcomes.

Unfortunately, reducing risk factors does not always prevent strokes, so secondary prevention is needed, which is covered in Section 5. Multiple clinical trials covering anticoagulation as well as blood pressure and cholesterol lowering treatments are reviewed. Then the authors discuss invasive techniques including carotid endarterectomies, stenting, and other vascular interventions. Two chapters are dedicated to the complexities of carotid endarterectomy, including patient selection and risk factors in clinical trials. Carotid endarterectomies involve significant morbidity and mortality potential, so the risks and benefits of the procedures are systematically discussed in addition to appropriate interventions for asymptomatic carotid stenosis.

In the final Section 6, the authors address “Miscellaneous Disorders,” although two of the four chapters are on vascular cognitive impairment. The first two chapters in this section cover cerebral venous thrombosis and spontaneous subarachnoid hemorrhage (SAH). The former chapter describes the clinical signs, diagnosis, and treatment of venous thrombus. In addition to SAH, the latter chapter also describes aneurysms as well as causes, epidemiology, secondary risks, and other complications. The final two chapters review clinical trial definitions and features of vascular cognitive impairment, including the overlap with Alzheimer’s disease. As with the other chapters, these concepts are broad, and specific neuropsychological measures and profiles are not mentioned.

Overall, this is a well-written book that has much strength, including its thorough citations. This reference text is best suited for those who are in clinical or research vascular settings, and it may be as beneficial for someone who desires a general reference book; however, the brief descriptions may be too elementary. A limitation is that this book is uneven in its detailed description of some issues (i.e., defining epidemiology, aspects of clinical trails) with only brief acknowledgement of other topics (i.e., genetics, neurobehavioral syndromes). The authors use myriad CT, MRI, and various vascular scans to illustrate structural and vascular anomalies, but curiously some CT and MRI images are rotated 180 degrees, thus putting them upside-down. While still labeled correctly, the reasons for this choice is unclear and can be distracting. As with the text, the images are uneven in that some parts are described with arrows pointing to pathology, while other images are not. Some readers may not be familiar with the types of scans and anatomy in the images, so it would have been helpful to have had more labels to refer to in addition to normal anatomy. While a useful reference, future editions of Transient Ischemic Attack and Stroke: Diagnosis, Investigation, and Management would be even stronger with greater emphasis on behavioral and psychiatric sequelae as well as case studies.