Can J Neurol Sci
-
Cerebral vasospasm is a potentially devastating complication in patients with aneurysmal subarachnoid hemorrhage. The purpose of this article is to review the use of computed tomogram (CT) angiography and CT perfusion in the diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage and also assess their use in guiding treatment decisions. ⋯ Computed tomogram angiography can directly visualize arterial narrowing and CT perfusion is able to evaluate differences in perfusion parameters after aneurysmal subarachnoid hemorrhage with high sensitivity and specificity. CT perfusion is better at predicting which patients require endovascular treatment.
-
Bioethics is a new discipline which developed as modern medical and scientific breakthroughs surpassed the ability of traditional medical ethics to contend with unique ethical dilemmas. It evolved into an interdisciplinary discourse regarding the ethical and societal implications of medicine and the biomedical sciences. Wilder Penfield (1891-1976), celebrated neurosurgeon and neuroscientist, is rarely thought of as a "bioethicist," and his mention in texts on the history of bioethics is little more than a footnote. However, he appears to have contributed to the field of bioethics in a number of ways: through his solutions to the ethical problems posed by the unique form of surgery he developed; through his recognition of the limitations of traditional medical ethics; through his involvement of the public and other disciplines in ethical discussions; and through the impact that his work still has today in the area of bioethics termed "neuroethics."
-
We studied the safety of use of acute reperfusion therapies in patients with stroke- on- awakening using a computed tomographic angiography (Cta) based large vessel occlusion-good scan paradigm in clinical routine. ⋯ When carefully selected using Ct –Cta, by a good scan (aSpeCtS > 7) occlusion paradigm, acute reperfusion therapies in patients with stroke-on-awakening can be performed safely in clinical routine.
-
Patient registries represent an important method of organizing "real world" patient information for clinical and research purposes. Registries can facilitate clinical trial planning and recruitment and are particularly useful in this regard for uncommon and rare diseases. Neuromuscular diseases (NMDs) are individually rare but in aggregate have a significant prevalence. In Canada, information on NMDs is lacking. Barriers to performing Canadian multicentre NMD research exist which can be overcome by a comprehensive and collaborative NMD registry. ⋯ The CNDR is a new nationwide registry of patients with NMDs that represents an important advance in Canadian neuromuscular disease research capacity. It provides an innovative platform for organizing patient information to facilitate clinical research and to expedite translation of recent laboratory findings into human studies.
-
This systematic review examines the incidence and prevalence of traumatic spinal cord injury (SCI) in different countries worldwide and their trends over time. The literature search of the studies published between 1950 and 2012 captured 1,871 articles of which 64 articles on incidence and 13 articles on prevalence fulfilled the inclusion and exclusion criteria. The global incidence of SCI varied from 8.0 to 246.0 cases per million inhabitants per year. ⋯ In addition to regional differences regarding the prevalence rates of SCI across the globe, there has been a trend towards increasing prevalence rates over the last decades. Our results suggest a relatively broad variation of incidence and prevalence rates of SCI among distinctive geographic regions. These results emphasize the need for further studies on incidence and prevalence of SCI, and for international standards and guidelines for reporting on SCI.