Canadian Journal of Neurological Sciences最新文献

Sex Differences in Moderate-to-Severe Traumatic Brain Injury Randomized Controlled Trials. 中重度脑外伤随机对照试验中的性别差异。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-07 DOI: 10.1017/cjn.2024.283

Cecilia Flores-Sandoval, Heather M MacKenzie, Emma A Bateman, Keith Sequeira, Mark Bayley, Robert Teasell

{"title":"Sex Differences in Moderate-to-Severe Traumatic Brain Injury Randomized Controlled Trials.","authors":"Cecilia Flores-Sandoval, Heather M MacKenzie, Emma A Bateman, Keith Sequeira, Mark Bayley, Robert Teasell","doi":"10.1017/cjn.2024.283","DOIUrl":"10.1017/cjn.2024.283","url":null,"abstract":"Background: Understanding sex differences among persons with moderate-to-severe traumatic brain injury (TBI) is critical to addressing the unique needs of both males and females from acute care through to rehabilitation. Epidemiological studies suggest that 7 of every 10 persons with moderate-to-severe TBI are male, with females representing about 30%-33%.Objective: To examine the proportion of female and male individuals included in randomized controlled trials (RCTs) of interventions for moderate-to-severe TBI.Methods: A systematic review was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines up to and including December 2022 using MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO databases. Studies were included if they met the following criteria: (1) human participants with a mean age ≥18 years, (2) ≥50% of the sample had moderate-to-severe TBI and (3) the study design was a RCT. Data extracted included author, year, country, sample size, number of female/male participants and time post-injury.Results: 595 RCTs met the criteria for inclusion, published between 1978 and 2022, totaling 86,662 participants. The average proportion of female participants was 23.14%, and the percentage increased a small but significant amount over time. There was a significantly lower percentage of female participants in RCTs initiated in the acute phase (≤ 1 month) when compared with RCTs conducted in the chronic phase (≥ 6 months) post-injury (p < 0.001).Conclusions: Female participants are underrepresented in RCTs of moderate-to-severe TBI. Addressing this underrepresentation is critical to establish effective treatments for all persons with TBI.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updated Canadian Headache Society Migraine Prevention Guideline with Systematic Review and Meta-analysis. 加拿大头痛协会偏头痛预防指南更新版及系统综述和元分析。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-07 DOI: 10.1017/cjn.2024.285

Ioana Medrea, Paul Cooper, Marissa Langman, Claire H Sandoe, Farnaz Amoozegar, Wasif M Hussain, Ana C Bradi, Jessica Dawe, Meagan Guay, Francois Perreault, Stuart Reid, Candice Todd, Becky Skidmore, Suzanne N Christie

{"title":"Updated Canadian Headache Society Migraine Prevention Guideline with Systematic Review and Meta-analysis.","authors":"Ioana Medrea, Paul Cooper, Marissa Langman, Claire H Sandoe, Farnaz Amoozegar, Wasif M Hussain, Ana C Bradi, Jessica Dawe, Meagan Guay, Francois Perreault, Stuart Reid, Candice Todd, Becky Skidmore, Suzanne N Christie","doi":"10.1017/cjn.2024.285","DOIUrl":"10.1017/cjn.2024.285","url":null,"abstract":"Objective: We have updated the migraine prevention guideline of the Canadian Headache Society from 2012, as there are new therapies available, and additionally, we have provided guidelines for the prevention of chronic migraine, which was not addressed in the previous iteration.Methods: We undertook a systematic review to identify new studies since the last guideline. For studies identified, we performed data extraction and subsequent meta-analyses where possible. We composed a summary of the evidence found and undertook a modified Delphi recommendation process. We provide recommendations for treatments identified and additionally expert guidance on the use of the treatments available in important clinical situations.Results: We identified 61 studies that were included in this evidence update and identified 16 therapies we focused on. The anti-calcitonin gene-related peptide (CGRP) agents were approved by Health Canada between 2018 and 2024 and provide additional options for episodic and chronic migraine prevention. We also summarize evidence for the use of propranolol, topiramate and onabotulinumtoxinA in addition to anti-CGRP agents as treatments for chronic migraine. We have downgraded topiramate to a weak recommendation for use and gabapentin to a weak recommendation against its use in episodic migraine. We have weakly recommended the use of memantine, levetiracetam, enalapril and melatonin in episodic migraine.Conclusion: Based on the evidence synthesis, we provide updated recommendations for the prevention of episodic and chronic migraine utilizing treatments available in Canada. We additionally provided expert guidance on their use in clinical situations.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Look Back on the History of Cerebral Revascularization for Acute Ischemic Stroke: A Neurosurgeon's Perspective. 回顾急性缺血性脑卒中脑血管再通术的历史：神经外科医生的视角。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-05 DOI: 10.1017/cjn.2024.292

Jay Max Findlay

引用次数: 0

Analysis of Clinical Utility of Functional MRI in Neurosurgical Decision-Making in Focal Epilepsy. 功能磁共振成像在局灶性癫痫的神经外科决策中的临床实用性分析。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-05 DOI: 10.1017/cjn.2024.312

Christopher O'Grady, Antonina Omisade

{"title":"Analysis of Clinical Utility of Functional MRI in Neurosurgical Decision-Making in Focal Epilepsy.","authors":"Christopher O'Grady, Antonina Omisade","doi":"10.1017/cjn.2024.312","DOIUrl":"https://doi.org/10.1017/cjn.2024.312","url":null,"abstract":"Background: Functional MRI (fMRI) has proven valuable in presurgical planning for people with brain tumors. However, it is underutilized for patients with epilepsy, likely due to less data on its added clinical value in this population. We reviewed clinical fMRI referrals at the QEII Health Sciences Center (Halifax, Nova Scotia) to determine the impact of fMRI on surgical planning for patients with epilepsy. We focused on reasons for fMRI referrals, findings and clinical decisions based on fMRI findings, as well as postoperative cognitive outcomes.Methods: We conducted a retrospective chart review of patients who underwent fMRI between June 2015 and March 2021.Results: Language lateralization represented the primary indication for fMRI (100%), with 7.7% of patients also referred for motor and sensory mapping. Language dominance on the side of resection was observed in 12.8% of patients; in 20.5%, activation was adjacent to the proposed resection site. In 18% of patients, fMRI provided an indication for further invasive testing due to the risk of significant cognitive morbidity (e.g., anterograde amnesia). Further invasive testing was avoided based on fMRI findings in 69.2% of patients. Cognitive outcomes based on combined neuropsychological findings and fMRI-determined language dominance were variable.Conclusion: fMRI in epilepsy was most often required to identify hemispheric language dominance. Although fMRI-determined language dominance was not directly predictive of cognitive outcomes, it helped identify patients at low risk of catastrophic cognitive morbidity and those at high risk who required additional invasive testing.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effect of After-Hours Resection on the Outcomes in Patients with High-Grade Gliomas. 小时后切除术对高级别胶质瘤患者疗效的影响

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-05 DOI: 10.1017/cjn.2024.314

Karan Dhillon, Michael A Rizzuto, Mostafa Fatehi, Serge Makarenko

{"title":"The Effect of After-Hours Resection on the Outcomes in Patients with High-Grade Gliomas.","authors":"Karan Dhillon, Michael A Rizzuto, Mostafa Fatehi, Serge Makarenko","doi":"10.1017/cjn.2024.314","DOIUrl":"https://doi.org/10.1017/cjn.2024.314","url":null,"abstract":"Objective: The \"weekend effect\" is the finding that patients presenting for medical care outside of regular working hours tend to have worse outcomes. There is a paucity of literature in the neuro-oncology space exploring this effect. We investigated the extent of resection and complication rates in patients undergoing after-hours high-grade glioma resection.Methods: A retrospective review was conducted on patients with high-grade glioma requiring emergent surgery between January 1, 2021, and March 31, 2023. After hours was defined as surgical resection on the weekend and/or evening (>50% of surgical time between 1630 and 0659). These patients were matched to patients undergoing resection during regular working hours. Groups were compared on the basis of the extent of resection, postoperative complications and 6-month mortality rate.Results: A total of 38 patients were included in this study (19 after hours, 19 regular hours). There was no significant difference in age, sex, tumor grade and tumor size between the two groups (all p > 0.05). There was no significant difference in the extent of resection between the groups (p = 0.7442). There was no significant difference in the rate of intraoperative complications, postoperative complications, reoperation and death at 6 months between the groups (all p > 0.05). Estimated blood loss was significantly higher in the regular hours group (p = 0.0278). There was no significant difference in the total operative time (p = 0.0643) and length of stay (p = 0.0601).Conclusions: After-hours high-grade glioma surgery has similar outcomes to regular-hours surgery for lesions not requiring specialized functional mapping.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Career Outcomes Among Neurosurgery Resident Graduates in Canada: An Update. 加拿大神经外科住院医师毕业生的职业前景：更新。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-04 DOI: 10.1017/cjn.2024.44

Lior M Elkaim, Farbod Niazi, Michael K Tso

{"title":"Career Outcomes Among Neurosurgery Resident Graduates in Canada: An Update.","authors":"Lior M Elkaim, Farbod Niazi, Michael K Tso","doi":"10.1017/cjn.2024.44","DOIUrl":"https://doi.org/10.1017/cjn.2024.44","url":null,"abstract":"Background: Many Royal College of Physicians and Surgeons of Canada (RCPSC) graduates in neurosurgery face significant challenges in finding full-time employment. The current study describes the career outcomes of neurosurgery residents from Canadian programs.Methods: All RCPSC neurosurgery graduates (n = 106) who completed their residency between 2015 and 2020 were included in this study. Baseline characteristics were determined for the entire cohort and then stratified by employment status. Several logistic regression models were used to identify predictors of full-time employment after residency.Results: Overall, 26.4% of neurosurgery graduates from 2015 to 2020 have been underemployed, defined as locum and clinical associate positions (6.6%), the pursuit of multiple fellowships (16%) and career change/nonsurgical career (3.8%). Only 52.0% of graduates were fully employed in Canada, with 30.2% appointed at academic institutions. Skull-base/open vascular (OR: 0.055, 95%CI [<0.01, 0.74]) and general neurosurgery (OR: 0.027, 95% CI [<0.01, 0.61]) fellowships were associated with underemployment. Advanced research degrees (master's or Ph.D.) and sex were not associated with full-time employment.Conclusions: Over one-quarter of recent Canadian neurosurgery graduates were underemployed, and nearly half do not find employment in Canada. These results reflect a concerning reality for current and prospective neurosurgery graduates in Canada and will hopefully serve as a call to action for the Canadian neurosurgery community.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extended delays in recognition of stroke symptoms and stroke code activation for in-hospital strokes: The DELAY study. 院内卒中症状识别和卒中代码激活的延迟时间延长：DELAY 研究。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-04 DOI: 10.1017/cjn.2024.304

Pamela N Correia, Justine Roy, Claire Haumesser, Lahoud Touma, Gregory Jacquin, Alexandre Y Poppe, Yan Deschaintre, Ariane Veilleux Carpentier

引用次数: 0

Recommendations on Imaging in the Context of Alzheimer's Disease Modifying Therapies from the CCNA Imaging Workgroup. CCNA 影像工作组关于阿尔茨海默病改变疗法背景下的影像建议。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-04 DOI: 10.1017/cjn.2024.338

Simon Duchesne, D Louis Collins, Laura Barlow, Robert Bartha, Sandra Black, Howard Chertkow, Mahsa Dadar, Manish Joshi, Pedro Rosa-Neto, Jean-Paul Soucy, Eric E Smith

引用次数: 0

Lack of Comprehensive Neural Antibody Testing: A Contributor to Diagnostic Delay in Autoimmune Encephalitis. 缺乏全面的神经抗体检测：自身免疫性脑炎诊断延迟的原因之一。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-04 DOI: 10.1017/cjn.2024.321

Jenan Al-Tawari, Mark A Tarnopolsky, Jorge G Burneo, Adrian Budhram

引用次数: 0

Anti-Myelin Oligodendrocyte Glycoprotein Antibodies and Acute Haemorrhagic Encephalomyelitis. 抗髓鞘少突胶质细胞糖蛋白抗体与急性出血性脑脊髓炎

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2024-11-04 DOI: 10.1017/cjn.2024.339

Say Ying Tan, Presaad Pillai, Jack Son Wee, Prabha Jaya Krishna, Yuen Kang Chia, Joshua Chin Ern Ooi

引用次数: 0