Clinical and Neuropsychological Aspects of Closed Head Injury (2nd edn) By John T. E. Richardson. Hove: Psychology Press. 2000. 246 pp. £29.95 (hb). ISBN 0 86377 7511

This is a second edition of a text first published in 1990. It has the considerable advantage of being single-authored and is written in an easily accessible style, the contents being a mixture of literature review and personal opinion, with sufficient referencing of the author's own work to be acceptable.

The book covers an important topic and should be of value to neurologists and psychiatrists, in both a clinical and a medico-legal setting. However, the title is misleading, as the text is very much concerned with neuropsychological aspects of head injury assessment and rehabilitation, and it is quite devoid of an appreciation of the psychiatric aspects of the area. This reflects the author's own area of expertise.

The text begins with a useful and well-presented description of neuroanatomical and pathological accounts of head injury in the literature. This is followed by an analysis of several important concepts, such as the amnesias, concussion and contusion, which leads into a detailed presentation of memory and its disorders of relevance for the head-injured patient. There follow chapters on cognition and language, subjective complaints and issues of management and rehabilitation.

Perhaps the main concerns with these helpful and comprehensive literature reviews are the author's lack of a critical eye, and, if the book is up to date, the paucity of literature that has emerged since the first edition. This reflects on the diversity of those involved in head-injury assessment and the variety of settings to which patients with head injuries are referred. Initially, it is a neurosurgical issue; the intermediate assessment of those patients continuing to have symptoms after a few months graduates to neurologists. Later, neuropsychologists, rehabilitation experts, psychiatrists and lawyers become involved. It is difficult not only to set up well-designed prospective long-term research projects, but also to gather a comprehensive overview of all that is involved.

This is a useful reference text, but it lacks that comprehensiveness, especially in the clinical assessment of the long-term neuropsychiatric sequelae. This is beyond the author's brief, but I was left thinking that we seem not much further on in many ways from the conclusions of Sir Charles Symonds, writing over 70 years ago: “The late effects of head injury can only be properly understood in the light of a full psychiatric study of the individual patient… it is not only the kind of injury that matters, but the kind of head”. We are still no good at measuring the latter!