Brain Injury Medicine. Principles and Practice

The essential thing is to develop in oneself the thirst for learning and understanding which may always prod us on. – Jawaharlal Nehru

A textbook on brain injury and management is picked by a neurosurgeon with some standard expectations, namely, that it will touch the epidemiology of traumatic brain injury (TBI), followed by chapters on pathophysiology, biomechanics, and then exhaustive description of neurosurgical lesions that warrant surgery. Brain injury medicine is a lot more, and makes a neurosurgeon introspect and realize that tackling only structural lesions is not the only endgame. A lot remains yet to be unfolded. There is a huge pool of knowledge waiting for translational channelizing into clinical practice. Admittedly, there are significant voids in the translational methodology and applications.

TBI is a lifelong disease is a reality and requires continuum of care from prehospital setting through acute care surgical procedures, onset of recovery, rehabilitation, return to work and community reentry, and beyond. Each of these may be working in silos and do not track recovery and other events in the continuum. TBI, especially the severe grade, has extended natural history and lifelong effects, with protracted recovery. Most often, it occurs early in life as compared with other devastating neurological disorders. And it is most ironic that most of these injuries are preventable. A large amount of text in the book is devoted to prevention of TBI and prehospital care.

There is extensive coverage of niche topics in TBI, namely, sports-related concussion, and functional neuroimaging in TBI, posttraumatic pain issues, cognitive and neurobehavioral disorders, and pediatric TBI including return to school. Neurological markers have been reviewed with little to recommend in the overall management of TBI. A chapter of life expectancy and wellness can assist the neurosurgeon to render an informed advice and counsel the patient and the family and caregivers. A special section deals with prevention of TBI, understandably the most vital aspect of TBI and the least discussed. There are sections on sports injuries including chronic traumatic encephalopathy, elder abuse, violence, and suicide. Assessment and treatment of posttraumatic fatigue makes the clinician aware of this entity, so far relegated to all-encompassing postconcussion syndrome. There are chapters on speech and swallowing disturbances following TBI, activities of daily living, and return to leisure skills.

A complete section on neuropharmacology opens the scope of pharmacological agents in neurorehabilitation, neuropsychiatry, and improvement of cognition. While critical care and acute rehabilitation are dealt with in the usual manner, a chapter on neurosurgical nursing and neurorehabilitation nursing covers an important aspect of paramedic training.

Principal merit of the book lies in appreciation of various aspects of brain response to TBI, something that enables a neurosurgeon to take an evidence-based approach in its overall management. For a practicing and academically inclined neurosurgeon or neuroscientist, the book provides multiple targets for enhancing knowledge on TBI, selecting a niche focus, and specialize in that focus. A section on ethics and medicolegal aspects forms a fitting finale to the awesome compilation of knowledge on TBI.

The sheer size and weight of the book is daunting. In more than 1,300 pages of two-column text, weighing approximately 10 pounds, that consolidates 19 sections and 91 chapters, it integrates available knowledge, experimental or clinical, into translational resource for the clinicians.

Besides the three principal editors, there is a vast team of contributors from practically every field of medical sciences, underscoring the fact that brain injury is not the exclusive domain of few. A psychologist and a rehabilitation nurse are important cogs in the wheel.

Printer's devil: Page 360 mentions “Traumatic Intraparenchymal Gematomas.” I'm certain the proofreaders and even the spell check missed that.

I am sure this book's addition to a departmental, institutional, or personal library will be welcomed by neurosurgeons, neuroscientists, researchers, nursing, and rehabilitation practitioners as a hugely valuable reference source.

Zasler ND, Katz DI, Zafonte RD, eds. Brain Injury Medicine: Principles and Practice. 3rd ed. New York, NY: Demos Medical (Springer); 2021. List price: US $314

Conflict of Interest

None declared.

Publication History

Article published online:
12 November 2025