Can J Neurol Sci
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Recurrence of chronic subdural haematomas (CSDHs) after surgical drainage is a significant problem with rates up to 20%. This study focuses on determining factors predictive of haematoma recurrence and presents a scoring system stratifying recurrence risk for individual patients. ⋯ Septations within CSDHs are associated with larger post-operative residual haematoma collections requiring repeat drainage. When septations are clearly visible within a CSDH, craniotomy might be more suitable as a primary procedure as it allows greater access to a septated subdural collection. Our proposed scoring system combining haematoma volume, age, and presence of septations might be useful in identifying patients at higher risk for recurrence.
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To describe the social, clinical and use-patterns characteristics of medicinal marijuana use among patients with epilepsy (PWEs). ⋯ PWEs using medicinal marijuana have a common profile. They are usually young single men with drug-resistant epilepsy and psychiatric comorbidity. Most used marijuana before formal prescription and all believe the drug was effective on their seizure control. Because of the concurrent use of other antiseizure medications, it is complex to estimate the actual effect of marijuana.
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The Province of Ontario recognized the pressing need to improve the understanding, diagnosis, and treatment of brain disorders. It also recognized that maximizing the existing strengths through a province-wide integrated approach was a pivotal mechanism. ⋯ The goal of this article is to introduce the elements of the Ontario Brain Institute to the neuroscience community: the motivation for establishing it, the philosophy behind its creation, the principles guiding its development, the rapid evolution of its functional structure, the tools available to achieve its vision, and the management structure to ensure success. The singular goal of the Province and the Ontario Brain Institute is a comprehensive system that assures that basic research is embedded in the clinical system and is facilitating product development to accelerate benefits to both health and the economy of health: science with impact.
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Postgraduate neurosurgical education is undergoing significant reform, including transition to a competency-based training model. To support these efforts, the purpose of this study was to determine neurosurgical graduates' and program directors' (PDs) opinions about graduates' level of competence in reference to the 2010 Royal College Objectives of Training in Neurosurgery. ⋯ Graduating neurosurgical residents are perceived to possess a high level of proficiency in the majority of neurosurgical practice domains. Inadequate exposure during training or a perception that subspecialists should perform some procedures may contribute to cases where proficiency is not as high. The trends identified in this study could be monitored on an ongoing basis to provide supplemental data to guide curricular decisions in Canadian neurosurgical training.
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Randomized Controlled Trial
Pregabalin for the management of cervicogenic headache: a double blind study.
The primary objective was to evaluate the effects of pregabalin relative to placebo in patients with chronic unilateral cervicogenic headache. Primary and secondary end points: To assess the change from baseline in the frequency of cervicogenic headache days per 28-day period between placebo and treatment group. To assess the change from baseline in the intensity of headache, and health outcome measures. ⋯ In this study, primary objectives were achieved with a statistically significant change of ten days in frequency of headache days; with minor side effects that were well tolerated.