Canadian Journal of Neurological Sciences最新文献

{"title":"Neuropathology of Fatal Falls in Southwestern Ontario.","authors":"Rachel Chang, Akeida Elliott-Benjamin, Wenqing He, Qi Zhang","doi":"10.1017/cjn.2025.10378","DOIUrl":"10.1017/cjn.2025.10378","url":null,"abstract":"<p><strong>Background: </strong>Fall from height is common in all age groups. In 2020 alone, over 6000 people in Canada died from fall-related injuries. Most of the published literature investigating fall-related injuries are often focused on fracture patterns, survival and recovery. Fatal falls are not well studied. The objective of this study is to characterize the demographics and craniocerebral and vertebrospinal injury patterns related to fatal falls within Southwestern Ontario.</p><p><strong>Methods: </strong>A retrospective case review was conducted at the Department of Pathology, London Health Sciences Centre, for deaths attributed to falls from 2000 to 2020. Only cases with complete autopsy and detailed neuropathology reports were included. Demographic data, comorbidity profiles and craniocerebral and vertebrospinal injuries, along with scene details, were collected and analyzed.</p><p><strong>Results: </strong>45 cases were included, with a male sex predominance and a mean age of 60.3 ± 18.1 years. The most common head injuries were hematoma, cerebral contusions and skull base fractures. Falls from stairs were the most common. Low fall (<3 m) was associated with subfalcine herniation and was more commonly seen in older individuals (>65 years). Younger individuals were more prone to falls from a high height (>3 m), with frontotemporal lobe contusions as the most common finding.</p><p><strong>Discussion: </strong>This study provides a detailed depiction of craniocerebral and vertebrospinal injury patterns of the fatal falls in Southwestern Ontario. Our findings show low falls are a more common cause of fatalities in individuals 65 years and older, and age is a significant predictor of frontal contusions and subdural hematomas.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710009","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}

{"title":"Early Motor Glasgow Coma Scale Predicts Unfavorable Functional Outcome after Poor-Grade Subarachnoid Hemorrhage.","authors":"Airton Leonardo de Oliveira Manoel, Fernando Godinho Zampieri, Alberto Goffi, Gisele Sampaio Silva, Sandro B Rizoli, Menno R Germans, Thomas R Marotta","doi":"10.1017/cjn.2025.10373","DOIUrl":"10.1017/cjn.2025.10373","url":null,"abstract":"<p><strong>Background: </strong>We assessed whether the motor component of the Glasgow Coma Scale (GCSm) is independently associated with unfavorable outcomes in aggressively treated poor-grade subarachnoid hemorrhage (SAH) patients.</p><p><strong>Methods: </strong>Retrospective cohort of poor-grade SAH patients (World Federation of Neurosurgical Societies (WFNS) grades IV and V). The best GCSm score achieved within 24 h of admission was stratified into four categories (<4, 4, 5 or 6). Outcomes were classified as favorable [modified Rankin Scale (mRS) ≤ 2] or unfavorable (mRS ≥ 3). Multivariable logistic regression was performed to identify independent predictors of unfavorable outcome.</p><p><strong>Results: </strong>A total of 179 patients were admitted during the study period (mean age 55.9 ± 12.1; 68.2% female). Thirty-three patients (33/179 - 18%) died before aneurysm treatment, one patient had missing GCSm data at 24 h and sixteen patients (16/179; 9%) were lost to follow-up. One hundred and twenty-nine patients (129/179 - 72%) were included in the final analysis. No patient with GCSm < 4 had a favorable outcome (sensitivity 22.4%, specificity 100%, positive predictive value 100% and negative predictive value 67.8% for unfavorable outcome). Delayed cerebral ischemia-related cerebral infarction (odds ratio (OR) 4.06; 1.56-11.11 95% CI, <i>p</i> = 0.004) and the best GCSm score were independently associated with unfavorable outcome. There was a stepwise decrease in the rate of unfavorable outcome from GCSm < 4 to GCSm = 6 (<4 = 100%; 4 = 80%; 5 = 46% and 6 = 20%). Each one-point decrease in GCSm score was associated with an OR of 3.52 (1.77-7.92 95% CI, <i>p</i> = < 0.001) for unfavorable outcome.</p><p><strong>Conclusion: </strong>The GCSm score was independently associated with unfavorable outcome. All patients with a GCSm score < 4 experienced an unfavorable outcome.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700452","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}

{"title":"Initial Comparison of Routine Electroencephalography and Event-Related Potentials in Patients with Cognitive Complaints.","authors":"George Medvedev, Eric D Kirby, Kaitlin Harding, Margit Glashutter, Tory O Frizzell, Xiaowei Song, Ryan C N D'Arcy","doi":"10.1017/cjn.2025.10362","DOIUrl":"10.1017/cjn.2025.10362","url":null,"abstract":"<p><p>Routine electroencephalograms (EEGs) assess brain function, but can be time-consuming, resource-intensive and setting-restrictive. Brain vital signs (BVS) evaluation, derived from EEG-based event-related potentials (ERPs), offers a rapid, standardized evaluation of cognitive function. In this study, 20 outpatients with cognitive complaints underwent both routine EEGs and BVS evaluation. While only 4 participants showed abnormal EEG results, 11 had at least one of the six BVS out-of-range, suggesting increased sensitivity to cognitive impairment. This commentary discusses the feasibility and potential value of standardized BVS evaluation as a simple objective method for cognitive function evaluation.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-5"},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700453","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}

{"title":"Role of RNF213 in Guiding Treatment of Moyamoya Disease with Unusual Phenotypic Presentation.","authors":"Jayanta Roy, Shramana Deb, Ritwick Mondal, Gourav Shome, Bijoy K Menon, Ananya Sengupta, Nirmalya Ray, Mona Tiwari, Subhadeep Banerjee, Avik Mukherjee, Sukalyan Purkayastha, Purbita Sen, Julián Benito-León, Mousumi Hazra, Saugata Hazra","doi":"10.1017/cjn.2025.10371","DOIUrl":"10.1017/cjn.2025.10371","url":null,"abstract":"<p><strong>Background: </strong>Moyamoya disease (MMD) is characterized by progressive carotid fork steno-occlusion and the development of \"puff-of-smoke\" collaterals on angiography. However, a subset of patients present with similar vascular changes but lack these hallmark collaterals, complicating both diagnosis and management. This \"smokeless\" phenotype, associated with ring finger protein 213 (RNF213) gene variants, challenges the traditional description of MMD. We describe a series of such patients who responded favorably to revascularization.</p><p><strong>Methods: </strong>In this ambispective observational study, we evaluated 12 patients with carotid fork steno-occlusive disease but without \"puff-of-smoke\" collaterals. Clinical, radiological and genetic assessments were assessed. Structural modeling of RNF213 protein variants was conducted through 3D homology modeling, validated via Ramachandran plots and further refined with COOT and PyMOL. Functional insights were derived through ConSurf analysis.</p><p><strong>Results: </strong>Of the 12 patients, 9 carried the RNF213 p.R4810K variant, 1 harboured a novel variant, 1 had both p.R4810K and a novel variant and 1 had p.R4859K. Initial misclassification as intracranial atherosclerosis or vasculitis led to inappropriate treatment. Following genetic confirmation, 9 patients underwent revascularization, with no stroke recurrence and a favorable clinical outcome. Structural modeling revealed minimal functional impact for the Val1529Met variant, whereas other variants significantly disrupted RNF213 stability and functionality.</p><p><strong>Conclusions: </strong>\"Smokeless moyamoya,\" characterized by carotid fork steno-occlusion without typical angiographic collaterals, represents a distinct clinical phenotype responsive to revascularization. RNF213 genetic screening enhances diagnostic precision, reshaping traditional paradigms and supporting tailored therapeutic approaches.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683664","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}

{"title":"Metamorphopsia in a Male with Parkinson Disease: A Giant Problem?","authors":"Eric Noyes, Natasha Gattey, Jenna Reding, Alex Rajput","doi":"10.1017/cjn.2025.10375","DOIUrl":"10.1017/cjn.2025.10375","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676676","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}

{"title":"Anti-NMDA receptor encephalitis in a patient with 18p deletion syndrome.","authors":"Marlene Rong, Jennifer A McCombe","doi":"10.1017/cjn.2025.10374","DOIUrl":"https://doi.org/10.1017/cjn.2025.10374","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676675","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}

{"title":"Practice Pearls: Spinal Myxopapillary Ependymoma Masquerading as Charcot-Marie Tooth (CMT) Disease.","authors":"Kate McMullen, Moises Maria, Charles D Kassardjian","doi":"10.1017/cjn.2025.10376","DOIUrl":"10.1017/cjn.2025.10376","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-3"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676677","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}

{"title":"The Eastern Quebec Study on Idiopathic Normal Pressure Hydrocephalus: Patient Characteristics and Demographic Insights.","authors":"Florence Belzile-Marsolais, Sophie Chantal, Adéline Nolin, Yannick Nadeau, Louis Verret, Carol Hudon","doi":"10.1017/cjn.2025.10363","DOIUrl":"10.1017/cjn.2025.10363","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbances, cognitive impairment and urinary dysfunction. Early diagnosis is essential to ensure timely shunt treatment. However, patient identification remains challenging due to limited studies, mostly from Asia and Europe, which restrict generalizability to other geographic areas. Moreover, demographic factors (age, sex, education) influence cognitive and gait performance in other neurological conditions, but their impact on iNPH remains unclear. This study aimed to characterize the demographic, vascular, cognitive and gait profiles of iNPH patients in Eastern Quebec (Canada) and determine how demographic factors influence performance outcomes.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on 175 patients diagnosed with probable iNPH at a specialized neurology center in Eastern Quebec. Demographic data, vascular risk factors and cognitive and gait outcomes were extracted from medical records. Descriptive statistics were used to characterize the sample, and multiple linear regressions assessed the effect of demographic factors on performance outcomes.</p><p><strong>Results: </strong>The cohort had a mean age of 73.9 years and a mean education level of 11.9 years. Age and education significantly predicted over half of the cognitive test results, while age was the only significant predictor of gait. Hypertension (58%) and hyperlipidemia (47%) were more prevalent than diabetes (26%), differing from previous studies where diabetes was the second most reported vascular risk factor after hypertension.</p><p><strong>Conclusions: </strong>Clinical heterogeneity characterizes iNPH patients in Eastern Quebec. Differences in the prevalence of vascular risk factors compared to previous studies may reflect geographic variability in the clinical presentation of this condition.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676678","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}

{"title":"The Prevalence and Long-Term Outcomes of Headaches after Aneurysmal Subarachnoid Hemorrhage: A Systematic Review - CORRIGENDUM.","authors":"Youngkyung Jung, Natália Vasconcellos de Oliveira Souza, Teruko Kishibe, Fatma Ger Akarsu, Edwin Wong, Eduardo Pimenta Ribeiro Pontes Almeida, Arthur Tung, Mohamad Kesserwan, Katrina Hannah Ignacio, Marie Charmaine Cootauco Sy, Nico Dimal, Karl Narvacan, Jimmy Li, Pamela Danielle T Lanuza, Jack Shujie Li, Abdelsimar Tan Omar, Vitor Mendes Pereira, Julian Spears, Thomas R Marotta, Atif Zafar, Manav V Vyas, Gustavo Saposnik, Jose Danilo Bengzon Diestro","doi":"10.1017/cjn.2025.10349","DOIUrl":"https://doi.org/10.1017/cjn.2025.10349","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661123","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}

{"title":"Early Exposure to Neurosurgery: Assessment of Perceptions, Mentorship and Competence on Medical Student Interest.","authors":"Saman Arfaie, Farbod Niazi, Reza Hazrati, Zeel Patel, Abrar Ahmed, Retage Al-Bader, Crystal Ma, Franciska Otaner, Sina Zamiri, Ashish Kumar","doi":"10.1017/cjn.2025.10129","DOIUrl":"https://doi.org/10.1017/cjn.2025.10129","url":null,"abstract":"<p><strong>Background: </strong>Neurosurgery is a demanding specialty, and a trainee's exposure to its tenets is usually achieved through residency. Medical students only access neurosurgical knowledge via brief stints in clerkships/electives and often lack mentorship and early exposure. This study sought to investigate the varying expectations about neurosurgical training held by Canadian medical students, with the goal of determining the impact of early exposure through educational opportunities and mentorship in developing interest and familiarity in the field.</p><p><strong>Methods: </strong>A cross-sectional study across Canada was conducted where students were provided with a 35-point questionnaire pertaining to mentorship, educational opportunities and interests regarding neurosurgery through REDcap. Questions were open-ended, closed-ended (single choice) or five-point Likert scale (matrix format). Interest in pursuing neurosurgery was selected as the primary outcome of this study and was dichotomized into high or low interest. Predictors of interest were determined using multivariable logistic regressions.</p><p><strong>Results: </strong>A total of 136 students from 14 accredited Canadian medical schools responded to the study. Most (55.9%) had prior exposure, and the most commonly reported deterring factors were work-life balance (94.5%) and family (84.6%). Predictors of interest included participation in relevant case-based discussion (OR = 2.644, 95% CI [1.221-5.847], <i>p</i> = 0.015) and involvement in neurosurgical research encouraged by home institution (OR = 1.619, 95% CI [1.124-2.396], <i>p</i> = 0.012).</p><p><strong>Discussion: </strong>Future efforts to improve student interest should focus on early exposure to the field such as developing pre-clerkship neurosurgical electives or medical student groups focused on neurosurgery.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651282","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}