Book excerpt: This unique text takes a comprehensive approach to the care of patients with neurologic catastrophes immediately after their entry into the emergency department. Wijdicks discusses clinical evaluations, triage, and emergency procedures in detail, and covers many other topics. For this thoroughly updated second edition, he has added eight new chapters, seven of which appear in an entirely new first section on the evaluation of presenting symptoms indicating urgency. The conversational titles of these chapters echo common requests for urgent consultation (e.g. "short of breath," "can't walk or stand," "confused and febrile"). A special feature of this section is the use of algorithms and decision trees in triage - to help the physician make a very fast and yet informed decision. The remaining two sections of the book cover the evaluation and management of evolving catastrophes in the neuraxis and catastrophic neurologic disorders due to specific causes. There is a final new chapter on forensic neurology. This practical handbook will continue to be an invaluable guide for neurologists, neurosurgeons, neuroradiologists, emergency physicians, and their residents and fellows. The third volume in the author's trilogy on critical care neurology, it combines the images of a neuroradiology text with the practical advice of an emergency neurology manual without compromising academic rigor.