Abstract
Headache And Other Head Pain, now familiarly known as Wolff's Headache, first appeared in 1948 as a monograph by the headache pioneer Harold Wolff. Following his death after the second edition, several prominent editors have guided it into today's comprehensive, multiauthored format. Wolff's Headache has long been considered a “bible” of headache medicine, and the current edition strives to maintain, even strengthen, that position. The editors have assembled a stellar cast of today's preeminent specialists, each writing on his or her particular area of expertise. The editors are to be commended for recruiting this pantheon, and for keeping their contributions generally consistent and readable over the length of the book. The content of Wolff's Headache has changed substantially over the 60 years since its inception, reflecting the far greater knowledge we now have of this disorder. The current edition is exceptionally strong in presenting the scientific basis of headache, with emphasis on an evidence-based approach throughout. Anatomy and pathophysiology are thoroughly, if a bit densely, covered, and reflect cutting-edge thinking as of publication date. Wherever possible, experimental results are cited to support theories and treatment options. Areas of controversy, such as the roles of botulinum toxin and nerve blocks, are clearly identified as such and the evidence is laid out with a very even hand. There is considerably less psychological speculation about headache patients than in some previous editions, which makes for perhaps less reader amusement but definitely more scientific credibility. Wolff's Headache is somewhat less successful as a clinical reference. In the drive to provide solid scientific motivation, clinical clarity is occasionally sacrificed. This is especially evident in the exceedingly long chapter on migraine treatment. In it, each possible abortive or preventive drug is introduced with a long pharmacological discussion and very detailed descriptions of its clinical trial results. This means that the rationale for using each drug is very well developed, but it also results at times in an impenetrable thicket of trial details. It is not easy to compare treatments with this approach, which also can appear to favor more recently developed drugs over older, less strictly studied, but still useful ones. There are some good tables on drug interactions and cautions near the end, but it's a long read to get there. It would have been better to subdivide this subject into shorter, more focused chapters. Other sections, dealing with more limited topics, are more successful. The treatment of trigeminal autonomic cephalgias, such as cluster and its relatives, is particularly lucid. Secondary headaches are covered in several fairly short, circumscribed chapters that are easy to reference. The special concerns of the female, geriatric, and pediatric populations are treated individually and are well worth reading. Headache in the emergency department is nicely presented, importantly including diagnostic pitfalls and appropriate testing; it also meshes well with an excellent chapter on imaging. For the puzzled clinician there is a usefully terse chapter on “turning failure to success,” although it does not address treatment in detail. There are some technical issues with this edition, unfortunately. The illustrations are well chosen, but suffer from editing problems. It appears that several plates were submitted in color, but reproduced in black-and-white without amending the captions. Multiple typographic and formatting errors also plague the tables, other figures, and the text itself. Most of the time it's possible to decipher all this, but not always. The index is also erratic, compounding the book's problems as a clinical reference. Despite these flaws, Wolff's Headache is still an important book, one which headache specialists will gladly place on their bookshelves between the seventh and, eventually, ninth editions. There is much to recommend it to nonspecialists as well, especially those who want to expand on their too-often rudimentary training in this important topic. Prose: ★★★★ Illustrations: ★★ Science: ★★★★ Usefulness: ★★★ Correspondence:Dr Geweke, Department of Neurology, University of Iowa, 200 Hawkins Dr, 2RCP, Iowa City, IA 52242 (lynne-geweke@uiowa.edu).
Journal
Archives of Neurology
– American Medical Association
Published: Apr 1, 2009
