Kevin Yen, Pouria Torabi, Janis M Miyasaki, Tejas Sankar, Fang Ba
{"title":"Quality Improvement in Deep Brain Stimulation for Movement Disorders: Pandemic Impact on Specialized Elective Surgery.","authors":"Kevin Yen, Pouria Torabi, Janis M Miyasaki, Tejas Sankar, Fang Ba","doi":"10.1017/cjn.2024.353","DOIUrl":"https://doi.org/10.1017/cjn.2024.353","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-16"},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787833","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}
Gurpreet Chaggar, Arth Pahwa, Brian H Buck, Thomas Jeerakathil, Ashfaq Shuaib, Mohammed Almekhlafi, Richard Swartz, Asif Butt, Luciana Catanese, Nishita Singh, Aleksander Tkach, Tolulope T Sajobi, Bijoy K Menon, Mahesh Kate
Background: The Edmonton-based mobile stroke unit (MSU), which transports patients to the University of Alberta Hospital (UAH), enrolled patients in the Intravenous Tenecteplase Compared with Alteplase for Acute Ischemic Stroke (AcT) trial. We examined the feasibility of trial enrollment in MSU, its impact on acute stroke workflow metrics and functional outcomes at 90-120 days.
Methods: In this post hoc analysis, patients were divided into three groups based on enrollment site: MSU (n = 43), UAH (n = 273) and non-UAH (n = 1261). All patients were enrolled with a deferred consent process. The primary outcome for this analysis was the feasibility of enrollment defined as the proportion of patients receiving intravenous thrombolysis (IVT) during the study period who were enrolled in the trial. Multiple linear and binary logistic regression was used to evaluate the adjusted effect of the study groups on acute stroke workflow metrics and functional outcomes at 90-120 days.
Results: 100% of eligible IVT-treated patients in the MSU during the study period were enrolled in the AcT trial. Covariate-adjusted linear regression showed shorter door-to-needle (17.2 [9.7-24.6] min) and CT-to-needle (10.7 [4.2-17.1] min) times in the MSU compared to UAH and non-UAH sites. There was no difference in the proportion of patients with an excellent functional outcome (mRS 0-1) at 90-120 days or symptomatic intracerebral hemorrhage (ICH) at 24 hours between groups.
Conclusions: Enrollment in the AcT trial from the MSU was feasible. MSU-enrolled patients demonstrated faster door-to-needle and CT-to-needle times, resulting in earlier IVT administration and similar rates of symptomatic ICH.
{"title":"Impact of Clinical Trial Enrollment on Thrombolysis Workflow in a Mobile Stroke Unit: Results from the AcT Trial.","authors":"Gurpreet Chaggar, Arth Pahwa, Brian H Buck, Thomas Jeerakathil, Ashfaq Shuaib, Mohammed Almekhlafi, Richard Swartz, Asif Butt, Luciana Catanese, Nishita Singh, Aleksander Tkach, Tolulope T Sajobi, Bijoy K Menon, Mahesh Kate","doi":"10.1017/cjn.2024.354","DOIUrl":"10.1017/cjn.2024.354","url":null,"abstract":"<p><strong>Background: </strong>The Edmonton-based mobile stroke unit (MSU), which transports patients to the University of Alberta Hospital (UAH), enrolled patients in the Intravenous Tenecteplase Compared with Alteplase for Acute Ischemic Stroke (AcT) trial. We examined the feasibility of trial enrollment in MSU, its impact on acute stroke workflow metrics and functional outcomes at 90-120 days.</p><p><strong>Methods: </strong>In this post hoc analysis, patients were divided into three groups based on enrollment site: MSU (<i>n</i> = 43), UAH (<i>n</i> = 273) and non-UAH (<i>n</i> = 1261). All patients were enrolled with a deferred consent process. The primary outcome for this analysis was the feasibility of enrollment defined as the proportion of patients receiving intravenous thrombolysis (IVT) during the study period who were enrolled in the trial. Multiple linear and binary logistic regression was used to evaluate the adjusted effect of the study groups on acute stroke workflow metrics and functional outcomes at 90-120 days.</p><p><strong>Results: </strong>100% of eligible IVT-treated patients in the MSU during the study period were enrolled in the AcT trial. Covariate-adjusted linear regression showed shorter door-to-needle (17.2 [9.7-24.6] min) and CT-to-needle (10.7 [4.2-17.1] min) times in the MSU compared to UAH and non-UAH sites. There was no difference in the proportion of patients with an excellent functional outcome (mRS 0-1) at 90-120 days or symptomatic intracerebral hemorrhage (ICH) at 24 hours between groups.</p><p><strong>Conclusions: </strong>Enrollment in the AcT trial from the MSU was feasible. MSU-enrolled patients demonstrated faster door-to-needle and CT-to-needle times, resulting in earlier IVT administration and similar rates of symptomatic ICH.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787814","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}
Thalia S Field, M Patrice Lindsay, Theodore Wein, Derek B Debicki, Johnathon Gorman, Manraj K S Heran, Leonard A Levin, Rebecca Lund, Mahendranath Moharir, Lissa Peeling, Kanjana S Perera, Deborah Siegal, Steve Verreault, Norine Foley, Chelsy Martin, Eric E Smith, Anita Mountain, Jennifer Mandzia
{"title":"Canadian Stroke Best Practice Recommendations, 7th Edition: Cerebral Venous Thrombosis, 2024 - CORRIGENDUM.","authors":"Thalia S Field, M Patrice Lindsay, Theodore Wein, Derek B Debicki, Johnathon Gorman, Manraj K S Heran, Leonard A Levin, Rebecca Lund, Mahendranath Moharir, Lissa Peeling, Kanjana S Perera, Deborah Siegal, Steve Verreault, Norine Foley, Chelsy Martin, Eric E Smith, Anita Mountain, Jennifer Mandzia","doi":"10.1017/cjn.2024.350","DOIUrl":"https://doi.org/10.1017/cjn.2024.350","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787812","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}
Pattarawut Charatpangoon, Nishita Singh, Brian H Buck, Federico Carpani, Luciana Catanese, Shelagh B Coutts, Thalia S Field, Gary Hunter, Houman Khosravani, Kanjana Perera, Tolulope T Sajobi, Michel Shamy, Jai Jai Shiva Shankar, Aleksander Tkach, Richard H Swartz, Mohammed A Almekhlafi, Bijoy K Menon, M Ethan MacDonald, Aravind Ganesh
{"title":"Automatic Matching Algorithms to Identify Eligible Participants for Stroke Trials: A Proof-of-Concept Study.","authors":"Pattarawut Charatpangoon, Nishita Singh, Brian H Buck, Federico Carpani, Luciana Catanese, Shelagh B Coutts, Thalia S Field, Gary Hunter, Houman Khosravani, Kanjana Perera, Tolulope T Sajobi, Michel Shamy, Jai Jai Shiva Shankar, Aleksander Tkach, Richard H Swartz, Mohammed A Almekhlafi, Bijoy K Menon, M Ethan MacDonald, Aravind Ganesh","doi":"10.1017/cjn.2024.352","DOIUrl":"https://doi.org/10.1017/cjn.2024.352","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-28"},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781949","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}
Sohaila Alshimemeri, Lamya Alsaghan, Danah Abo Alsamh, Lily Zhou, Sarah Furtado, Scott Kraft, Veronica Bruno, Silke Appel-Cresswell, Antoine Duquette, Bernard Brais, Oksana Suchowersky, Elizabeth Slow, Renato P Munhoz
Background: There is limited information on rare spinocerebellar ataxia (SCA) variants, particularly in the Canadian population. This study aimed to describe the demographic and clinical features of uncommon SCA subtypes in Canada and compare them with international data.
Methods: We conducted a case series and literature review of adult patients with rare SCA subtypes, including SCA5, SCA7, SCA12, SCA14, SCA15, SCA28, SCA34, SCA35 and SCA36. Data were collected from medical centers in Ontario, Alberta and Quebec between January 2000 and February 2021.
Results: We analyzed 25 patients with rare SCA subtypes, with onset ages ranging from birth to 67 years. Infantile and juvenile-onset cases were observed in SCA5, SCA7, SCA14 and SCA34. Most patients presented with gait ataxia, with no significant differences across groups. Additional common features included saccadic abnormalities (22 of 25), dysarthria (19 of 25) and nystagmus (12 of 22, except in SCA7). Less common findings included dystonia (8 of 25), cognitive impairment (7 of 25), tremor (9 of 25) and parkinsonism (3 of 25).
Conclusion: Our study highlights the heterogeneity of rare SCA subtypes in Canada. Ongoing longitudinal analysis will improve the understanding, management and screening of these disorders.
{"title":"Rare Spinocerebellar Ataxia Types in Canada: A Case Series and Review of the Literature.","authors":"Sohaila Alshimemeri, Lamya Alsaghan, Danah Abo Alsamh, Lily Zhou, Sarah Furtado, Scott Kraft, Veronica Bruno, Silke Appel-Cresswell, Antoine Duquette, Bernard Brais, Oksana Suchowersky, Elizabeth Slow, Renato P Munhoz","doi":"10.1017/cjn.2024.335","DOIUrl":"https://doi.org/10.1017/cjn.2024.335","url":null,"abstract":"<p><strong>Background: </strong>There is limited information on rare spinocerebellar ataxia (SCA) variants, particularly in the Canadian population. This study aimed to describe the demographic and clinical features of uncommon SCA subtypes in Canada and compare them with international data.</p><p><strong>Methods: </strong>We conducted a case series and literature review of adult patients with rare SCA subtypes, including SCA5, SCA7, SCA12, SCA14, SCA15, SCA28, SCA34, SCA35 and SCA36. Data were collected from medical centers in Ontario, Alberta and Quebec between January 2000 and February 2021.</p><p><strong>Results: </strong>We analyzed 25 patients with rare SCA subtypes, with onset ages ranging from birth to 67 years. Infantile and juvenile-onset cases were observed in SCA5, SCA7, SCA14 and SCA34. Most patients presented with gait ataxia, with no significant differences across groups. Additional common features included saccadic abnormalities (22 of 25), dysarthria (19 of 25) and nystagmus (12 of 22, except in SCA7). Less common findings included dystonia (8 of 25), cognitive impairment (7 of 25), tremor (9 of 25) and parkinsonism (3 of 25).</p><p><strong>Conclusion: </strong>Our study highlights the heterogeneity of rare SCA subtypes in Canada. Ongoing longitudinal analysis will improve the understanding, management and screening of these disorders.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775041","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}
Diana Chang, Satoshi Tateshima, Karam Han, Hilda Mirbaha, Charles Beaman, Geoffrey P Colby, Noriko Salamon, Harry V Vinters, Anthony C Wang
{"title":"Cerebellar Vascular Malformation of Unknown Aetiology with Recent COVID-19 Infection.","authors":"Diana Chang, Satoshi Tateshima, Karam Han, Hilda Mirbaha, Charles Beaman, Geoffrey P Colby, Noriko Salamon, Harry V Vinters, Anthony C Wang","doi":"10.1017/cjn.2024.301","DOIUrl":"https://doi.org/10.1017/cjn.2024.301","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741494","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}
Qais Sa'di, Saba Alsmadi, Wanas Shtaiyat, Mohammad Qasaimeh, Renato Puppi Munhoz
{"title":"FLVCR1 Gene Mutation in a Patient with an Atypical Multiple Sclerosis-Like Presentation.","authors":"Qais Sa'di, Saba Alsmadi, Wanas Shtaiyat, Mohammad Qasaimeh, Renato Puppi Munhoz","doi":"10.1017/cjn.2024.351","DOIUrl":"https://doi.org/10.1017/cjn.2024.351","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-12"},"PeriodicalIF":2.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734793","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}
Davis MacLean, Benjamin Beland, Gordon A E Jewett, Luca Bartolini, David J T Campbell, Malavika Varma, Ravinder-Jeet Singh, John H Wong, Bijoy K Menon, Aravind Ganesh
{"title":"Management Approaches to Intraluminal Thrombi in Acutely Symptomatic Carotid Stenosis.","authors":"Davis MacLean, Benjamin Beland, Gordon A E Jewett, Luca Bartolini, David J T Campbell, Malavika Varma, Ravinder-Jeet Singh, John H Wong, Bijoy K Menon, Aravind Ganesh","doi":"10.1017/cjn.2024.348","DOIUrl":"https://doi.org/10.1017/cjn.2024.348","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-27"},"PeriodicalIF":2.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734798","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}
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