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Volny O, Zerna C, Tomek A, Bar M, Rocek M, Padr R, Cihlar F, Nevsimalova M, Jurak L, Havlicek R, Kovar M, Sevcik P, Rohan V, Fiksa J, Cernik D, Jura R, Vaclavik D, Cimflova P, Puig J, Dowlatshahi D, Khaw AV, Fainardi E, Najm M, Demchuk AM, Menon BK, Mikulik R, Hill MD. Thrombectomy vs medical management in low NIHSS acute anterior circulation stroke. Neurology 2020; 95:e3364-e3372. [PMID: 32989100 DOI: 10.1212/wnl.0000000000010955] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/12/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To undertake an effectiveness and safety analysis of EVT in patients with LVO and NIH Stroke Scale (NIHSS) score ≤6 using datasets of multicenter and multinational nature. METHODS We pooled patients with anterior circulation occlusion from 3 prospective international cohorts. Patients were eligible if presentation occurred within 12 hours from last known well and baseline NIHSS ≤6. Primary outcome was modified Rankin Scale (mRS) score 0-1 at 90 days. Secondary outcomes included neurologic deterioration at 24 hours (change in NIHSS of ≥2 points), mRS 0-2 at 90 days, and 90-day all-cause mortality. We used propensity score matching to adjust for nonrandomized treatment allocation. RESULTS Among 236 patients who fit inclusion criteria, 139 received EVT and 97 received medical management. Compared to medical management, the EVT group was younger (65 vs 72 years; p < 0.001), had more proximal occlusions (p < 0.001), and less frequently received concurrent IV thrombolysis (57.7% vs 71.2%; p = 0.04). After propensity score matching, clinical outcomes between the 2 groups were not significantly different. EVT patients had an 8.6% (95% confidence interval [CI] -8.8% to 26.1%) higher rate of excellent 90-day outcome, despite a 22.3% (95% CI, 3.0%-41.6%) higher risk of neurologic deterioration at 24 hours. CONCLUSIONS EVT for LVO in patients with low NIHSS score was associated with increased risk of neurologic deterioration at 24 hours. However, both EVT and medical management resulted in similar proportions of excellent clinical outcomes at 90 days. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that for patients with acute anterior circulation ischemic strokes and LVO with NIHSS < 6, EVT and medical management result in similar outcomes at 90 days.
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Affiliation(s)
- Ondrej Volny
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Charlotte Zerna
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy.
| | - Ales Tomek
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Michal Bar
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Miloslav Rocek
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Radek Padr
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Filip Cihlar
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Miroslava Nevsimalova
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Lubomir Jurak
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Roman Havlicek
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Martin Kovar
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Petr Sevcik
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Vladimir Rohan
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Jan Fiksa
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - David Cernik
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Rene Jura
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Daniel Vaclavik
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Petra Cimflova
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Josep Puig
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Dar Dowlatshahi
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Alexander V Khaw
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Enrico Fainardi
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Mohamed Najm
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Andrew M Demchuk
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Bijoy K Menon
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Robert Mikulik
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
| | - Michael D Hill
- From the Department of Clinical Neurosciences, Calgary Stroke Program (O.V., C.Z., M.N., A.M.D., B.K.M., M.D.H.), and Department of Community Health Sciences (C.Z., B.K.M., M.D.H.), Cumming School of Medicine, University of Calgary, Canada; International Clinical Research Centre, Stroke Research Program & Department of Neurology (O.V., P.C., R.M.), and Department of Medical Imaging (P.C.), St. Anne's University Hospital; Faculty of Medicine (O.V., P.C., R.M.), Masaryk University, Brno; Department of Neurology (O.V.), Faculty Hospital Ostrava; 2nd Medical Faculty (A.T.) and First Faculty of Medicine and General University Hospital (J.F.), Department of Neurology, Charles University, Prague; Department of Neurology, Faculty of Medicine (M.B.), University Hospital Ostrava, University Ostrava; Department of Radiology, 2nd Faculty of Medicine (M.R., R.P.), Charles University in Prague and Motol University Hospital; Department of Radiology (F.C.) and Department of Neurology-Comprehensive Stroke Center (D.C.), Masaryk Hospital, Usti nad Labem; Department of Neurology (M.N.), Hospital Ceske Budejovice; Neurocenter (L.J.), Regional Hospital Liberec; Department of Neurology (R.H.), Military University Hospital, Prague; Department of Neurology (M.K.), Na Homolce Hospital, Prague; Department of Neurology, Faculty of Medicine in Pilsen (P.S., V.R.), Charles University in Prague, Pilsen; Department of Neurology (R.J.), University Hospital Brno and Faculty of Medicine Masaryk University; Department of Neurology (D.V.), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR) (J.P.), Parc Sanitari Pere Virgili, Barcelona; Girona Biomedical Research Institute (IDIBGI)-Medical Imaging (J.P.), Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain; Department of Clinical Neurosciences (D.P.), University of Western Ontario; Lawson Health Research Institute and Robarts Research Institute (A.V.K.), London, Canada; and Department of Experimental and Clinical Biomedical Sciences "Mario Serio" (E.F.), University of Florence, Italy
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