{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:26:47Z","timestamp":1794018407664,"version":"4.8.0"},"reference-count":8,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,9]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Intracranial infections complicating bacterial sinusitis are rare in children; however, an increase in these complications after the start of the COVID-19 pandemic has been suggested in certain geographies. Herein, the authors sought to describe the epidemiology of pediatric intracranial infections complicating bacterial sinusitis before and after the onset of the COVID-19 pandemic in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In this retrospective observational study, authors assembled a cohort of children with intracranial infective complications of bacterial sinusitis that were treated operatively and nonoperatively from 2016 to 2022. Case counts over time were tabulated and compared (January 2016\u2013March 2020, before the COVID-19 pandemic [preonset] vs April 2020\u2013December 2022, after the onset of the COVID-19 pandemic [postonset]). Patient demographic, clinical, microbiological, operative, and outcome data were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Two hundred sixteen cases (106 preonset and 110 postonset) from 10 pediatric neurosurgical centers across 7 Canadian provinces were analyzed. Overall median quarterly case counts were similar in the period before (6 [IQR 5\u20138] cases\/quarter) and after (6 [IQR 5\u201313.5] cases\/quarter) pandemic onset (p = 0.51). However, examining the postonset period in smaller increments revealed a redistribution of cases, with fewer cases observed in the 18 months comprising the early pandemic period and a statistically significant and sustained increase in case counts in the subsequent 15 months of the late pandemic period. After pandemic onset, a significant increase in the proportion of children with intracranial infections secondary to sinusitis requiring neurosurgical intervention was observed (OR 2.35, 95% CI 1.30\u20134.27, p = 0.005), without a change in the distribution of risk factors for severe disease between preonset and postonset periods. No pandemic-related differences in the microbiological profile or outcomes were observed, and there was no evidence of disruption to the functioning of the healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>After a short period of reduced counts of intracranial infection cases due to bacterial sinusitis following the onset of the COVID-19 pandemic, Canadian centers experienced a sustained rise in case numbers until the end of the study period (December 2022). This increase together with a greater requirement for neurosurgical intervention appears to be responsible for the perception among members of the pediatric neurosurgical community of an increase in the incidence of suppurative intracranial complications of bacterial sinusitis. Additional observational data are required to determine whether case counts return to prepandemic norms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.5.peds25668","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:01:25Z","timestamp":1791331285000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric intracranial infections complicating bacterial sinusitis in Canada"],"prefix":"10.3171","author":[{"given":"Christy","family":"Richards","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Weir","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olufemi","family":"Ajani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, McMaster University, Hamilton, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Drapeau","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, University of Manitoba, Winnipeg, Manitoba;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Molot-Toker","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, University of Manitoba, Winnipeg, Manitoba;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of Alberta, Edmonton, Alberta;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Radic","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"de Ribaupierre","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences, Western University, London, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matea","family":"Zuljevic","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences, Western University, London, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Riva-Cambrin","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Alberta;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruksana","family":"Rashid","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Alberta;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of Ottawa, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharini","family":"Sam Chee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of Ottawa, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Venne","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Universite de Montreal, Quebec; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Weil","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Universite de Montreal, Quebec; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marine","family":"Venne","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Universite de Montreal, Quebec; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Walling","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep S.","family":"Tamber","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Drugs Context","first-page":"2020-9","article-title":"Acute bacterial sinusitis in children: an updated review","volume":"9","author":"Leung AK","year":"2020","unstructured":"Leung AK, Hon KL, Chu WC. Acute bacterial sinusitis in children: an updated review. Drugs Context. 2020;9:2020-9\u20133. doi:10.7573\/dic.2020-9-3"},{"issue":"5","key":"b2","series-title":"J Neurosurg Pediatr","first-page":"479","article-title":"Intracranial complications secondary to acute bacterial sinusitis requiring neurosurgical intervention before and after the onset of the COVID-19 pandemic","volume":"34","author":"Flanders TM","year":"2024","unstructured":"Flanders TM, Kumar NK, Zhao C,  Intracranial complications secondary to acute bacterial sinusitis requiring neurosurgical intervention before and after the onset of the COVID-19 pandemic. J Neurosurg Pediatr. 2024;34(5):479\u2013488. doi:10.3171\/2024.5.PEDS2433"},{"issue":"2","key":"b3","series-title":"J Neurosurg Pediatr","first-page":"231","article-title":"Changes in the epidemiology of pediatric sinogenic and otogenic intracranial infections during the COVID-19 pandemic: a single-institution study","volume":"32","author":"Angelo SJ","year":"2023","unstructured":"Angelo SJ, Anderson MG, Sutter PA,  Changes in the epidemiology of pediatric sinogenic and otogenic intracranial infections during the COVID-19 pandemic: a single-institution study. J Neurosurg Pediatr. 2023;32(2):231\u2013241. doi:10.3171\/2023.4.PEDS23130"},{"issue":"4","key":"b4","series-title":"Childs Nerv Syst","first-page":"1221","article-title":"Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era","volume":"40","author":"Massimi L","year":"2024","unstructured":"Massimi L, Cinalli G, Frassanito P,  Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era. Childs Nerv Syst. 2024;40(4):1221\u20131237. doi:10.1007\/s00381-024-06332-9"},{"issue":"37","key":"b5","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1169","article-title":"Pediatric brain abscesses, epidural empyemas, and subdural empyemas associated with Streptococcus species\u2014United States, January 2016\u2013August 2022","volume":"71","author":"Accorsi EK","year":"2022","unstructured":"Accorsi EK, Chochua S, Moline HL,  Pediatric brain abscesses, epidural empyemas, and subdural empyemas associated with Streptococcus species\u2014United States, January 2016\u2013August 2022. 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MMWR Morb Mortal Wkly Rep. 2022;71(31):1000\u20131001. doi:10.15585\/mmwr.mm7131a4"},{"issue":"6","key":"b7","series-title":"J Neurosurg Pediatr","first-page":"567","article-title":"Intracranial suppuration complicating sinusitis among children: an epidemiological and clinical study","volume":"7","author":"Piatt JH Jr","year":"2011","unstructured":"Piatt JH Jr. Intracranial suppuration complicating sinusitis among children: an epidemiological and clinical study. J Neurosurg Pediatr. 2011;7(6):567\u2013574. doi:10.3171\/2011.3.PEDS10504"},{"issue":"6","key":"b8","series-title":"Pediatrics","first-page":"e1647","article-title":"Pediatric medical complexity algorithm: a new method to stratify children by medical complexity","volume":"133","author":"Simon TD","year":"2014","unstructured":"Simon TD, Cawthon ML, Stanford S,  Pediatric medical complexity algorithm: a new method to stratify children by medical complexity. Pediatrics. 2014;133(6):e1647\u2013e1654. doi:10.1542\/peds.2013-3875"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.5.PEDS25668\/article-10.3171-2026.5.PEDS25668.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.5.PEDS25668\/article-10.3171-2026.5.PEDS25668.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:16:23Z","timestamp":1794017783000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2026.5.PEDS25668\/article-10.3171-2026.5.PEDS25668.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":8,"URL":"https:\/\/doi.org\/10.3171\/2026.5.peds25668","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]}}}