{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:28:08Z","timestamp":1777609688202,"version":"3.51.4"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n\t  <jats:sec id=\"S0317167124003159_as1\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>Spinal CSF leak can cause disabling headaches and neurological symptoms. Lack of awareness, diagnostic delay and treatment inconsistencies affect the quality of CSF leak care globally. This is the first study aiming to identify and assess these challenges in Canada.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167124003159_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>A cross-sectional online survey of Canadian patients with spinal CSF leak was designed in collaboration with Spinal CSF Leak Canada, including questions on demographics, headache condition, investigations, treatments, quality of life, financial consequences and out-of-country care.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167124003159_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>The survey captured 103 respondents with confirmed spinal CSF leak diagnosis, of whom 56% were still suffering. The majority were female (80%), most being highly educated, with a mean age of 41.8 (SD: 10.37) years at the time of diagnosis. Inconsistencies in care resulted in variable durations for obtaining diagnosis and treatment. The majority of respondents (88%) had seen multiple physicians, and only 50% had seen a CSF leak specialist. Invasive imaging was not performed in 43%. CSF leak relapse after initial successful treatment occurred frequently (43%). The incidence of rebound intracranial hypertension was high (52.5%), and the treatment was difficult to access (77%). Out-of-country care was common (28%), and the impact on financial health was omnipresent (81.5%).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167124003159_as4\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>The survey demonstrates significant gaps in spinal CSF leak care in Canada, similar to global observations. Lack of awareness and access, delayed care, and inconsistencies in investigations and management are common. Spinal CSF leak significantly impacts patients\u2019 physical, mental and financial well-being. Increased awareness, referral pathways and standardized treatment algorithms are key factors in optimizing patient care in Canada.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/cjn.2024.315","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T11:46:46Z","timestamp":1731498406000},"page":"1-8","source":"Crossref","is-referenced-by-count":3,"title":["The Challenges of Patients with Spinal CSF Leaks in Canada: A Cross-Sectional Online Survey"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0893-8813","authenticated-orcid":false,"given":"Yasmine","family":"Hoydonckx","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Vydt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farnaz","family":"Amoozegar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,11,13]]},"reference":[{"key":"S0317167124003159_ref2","doi-asserted-by":"publisher","DOI":"10.1177\/03331024211048510"},{"key":"S0317167124003159_ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-024-01231-9"},{"key":"S0317167124003159_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-009-0060-8"},{"key":"S0317167124003159_ref19","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200290"},{"key":"S0317167124003159_ref1","first-page":"629","volume":"33","year":"2013"},{"key":"S0317167124003159_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/head.13328"},{"key":"S0317167124003159_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/head.14677"},{"key":"S0317167124003159_ref12","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2023-331166"},{"key":"S0317167124003159_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/15910199231165429"},{"key":"S0317167124003159_ref9","first-page":"745","article-title":"Spontaneous intracranial hypotension: a systematic imaging approach for CSF leak localization and management based on MRI and digital subtraction myelography","volume":"40","author":"Farb","year":"2019","journal-title":"AJNR Am J Neuroradiol"},{"key":"S0317167124003159_ref16","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.22.27485"},{"key":"S0317167124003159_ref20","unstructured":"20. Spinal Cerebrospinal Fluid (CSF) Leak of Canada (charitable organization), https:\/\/www.spinalcsfleakcanada.ca\/."},{"key":"S0317167124003159_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.06.018"},{"key":"S0317167124003159_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2013.11.002"},{"key":"S0317167124003159_ref7","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207763"},{"key":"S0317167124003159_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100013664"},{"key":"S0317167124003159_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00423-3"},{"key":"S0317167124003159_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.4799"},{"key":"S0317167124003159_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.nic.2019.07.006"},{"key":"S0317167124003159_ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057438"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167124003159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T11:46:50Z","timestamp":1731498410000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167124003159\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,13]]},"references-count":20,"alternative-id":["S0317167124003159"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2024.315","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,13]]}}}