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Nguyen TN, Haussen DC, Qureshi MM, Yamagami H, Fujinaka T, Mansour OY, Abdalkader M, Frankel M, Qiu Z, Taylor A, Lylyk P, Eker OF, Mechtouff L, Piotin M, Lima FO, Mont'Alverne F, Izzath W, Sakai N, Mohammaden M, Al-Bayati AR, Renieri L, Mangiafico S, Ozretic D, Chalumeau V, Ahmad S, Rashid U, Hussain SI, John S, Griffin E, Thornton J, Fiorot JA, Rivera R, Hammami N, Cervantes-Arslanian AM, Dasenbrock HH, Vu HL, Nguyen VQ, Hetts S, Bourcier R, Guile R, Walker M, Sharma M, Frei D, Jabbour P, Herial N, Al-Mufti F, Ozdemir AO, Aykac O, Gandhi D, Chugh C, Matouk C, Lavoie P, Edgell R, Beer-Furlan A, Chen M, Killer-Oberpfalzer M, Pereira VM, Nicholson P, Huded V, Ohara N, Watanabe D, Shin DH, Magalhaes PS, Kikano R, Ortega-Gutierrez S, Farooqui M, Abou-Hamden A, Amano T, Yamamoto R, Weeks A, Cora EA, Sivan-Hoffmann R, Crosa R, Möhlenbruch M, Nagel S, Al-Jehani H, Sheth SA, Lopez Rivera VS, Siegler JE, Sani AF, Puri AS, Kuhn AL, Bernava G, Machi P, Abud DG, Pontes-Neto OM, Wakhloo AK, Voetsch B, Raz E, Yaghi S, Mehta BP, Kimura N, Murakami M, Lee JS, Hong JM, Fahed R, Walker G, Hagashi E, Cordina SM, Roh HG, Wong K, Arenillas JF, Martinez-Galdamez M, Blasco J, Rodriguez Vasquez A, Fonseca L, Silva ML, Wu TY, John S, Brehm A, Psychogios M, Mack WJ, Tenser M, Todaka T, Fujimura M, Novakovic R, Deguchi J, Sugiura Y, Tokimura H, Khatri R, Kelly M, Peeling L, Murayama Y, Winters HS, Wong J, Teleb M, Payne J, Fukuda H, Miyake K, Shimbo J, Sugimura Y, Uno M, Takenobu Y, Matsumaru Y, Yamada S, Kono R, Kanamaru T, Morimoto M, Iida J, Saini V, Yavagal D, Bushnaq S, Huang W, Linfante I, Kirmani J, Liebeskind DS, Szeder V, Shah R, Devlin TG, Birnbaum L, Luo J, Churojana A, Masoud HE, Lopez CY, Steinfort B, Ma A, Hassan AE, Al Hashmi A, McDermott M, Mokin M, Chebl A, Kargiotis O, Tsivgoulis G, Morris JG, Eskey CJ, Thon J, Rebello L, Altschul D, Cornett O, Singh V, Pandian J, Kulkarni A, Lavados PM, Olavarria VV, Todo K, Yamamoto Y, Silva GS, Geyik S, Johann J, Multani S, Kaliaev A, Sonoda K, Hashimoto H, Alhazzani A, Chung DY, Mayer SA, Fifi JT, Hill MD, Zhang H, Yuan Z, Shang X, Castonguay AC, Gupta R, Jovin TG, Raymond J, Zaidat OO, Nogueira RG. Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic. Stroke Vasc Neurol 2021; 6:542-552. [PMID: 33771936 PMCID: PMC8006491 DOI: 10.1136/svn-2020-000695] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 02/07/2023] Open
Abstract
Background During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study’s objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March–31 May 2020. The prior 1-year control period (1 March–31 May 2019) was obtained to account for seasonal variation. Findings There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI −24.3% to −20.7%, p<0.0001). Embolisation of ruptured aneurysms declined with 1170–1035 procedures, respectively, representing an 11.5% (95%CI −13.5% to −9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI −28.0% to −22.1%, p<0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile. Interpretation There was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction.
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Affiliation(s)
- Thanh N Nguyen
- Neurology, Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Diogo C Haussen
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Muhammad M Qureshi
- Radiology, Radiation Oncology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Hiroshi Yamagami
- Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Toshiyuki Fujinaka
- Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | - Michael Frankel
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital, Chongqing, China
| | - Allan Taylor
- Neurosurgery, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Pedro Lylyk
- Neurosurgery, Interventional Neuroradiology, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Omer F Eker
- Neuroradiologie, Neurologie Vasculaire, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Laura Mechtouff
- Neurologie Vasculaire, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Michel Piotin
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | | | | | - Wazim Izzath
- Neuroradiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Nobuyuki Sakai
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Mahmoud Mohammaden
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Alhamza R Al-Bayati
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Leonardo Renieri
- Interventional Neurovascular Unit, University Hospital Careggi, Firenze, Toscana, Italy
| | - Salvatore Mangiafico
- Interventional Neurovascular Unit, University Hospital Careggi, Firenze, Toscana, Italy
| | - David Ozretic
- Neuroradiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Vanessa Chalumeau
- Interventional Neuroradiology, Hopital Bicetre, Le Kremlin-Bicetre, France
| | - Saima Ahmad
- Stroke and Interventional Neuroradiology, Lahore General Hospital, Lahore, Pakistan
| | - Umair Rashid
- Stroke and Interventional Neuroradiology, Lahore General Hospital, Lahore, Pakistan
| | | | - Seby John
- Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Emma Griffin
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - John Thornton
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | | | - Rodrigo Rivera
- Neuroradiology, Instituto de Neurocirugia Dr Asengo, Santiago, Chile
| | - Nadia Hammami
- Interventional Neuroradiology, Institut National de Neurologie, Tunis, Tunisia
| | | | | | - Huynh Le Vu
- Stroke Center, Hue Central Hospital, Hue, Thua Thien Hue, Vietnam
| | - Viet Quy Nguyen
- Stroke Center, Hue Central Hospital, Hue, Thua Thien Hue, Vietnam
| | - Steven Hetts
- Radiology, University of California San Francisco, San Francisco, California, USA.,Interventional Neuroradiology, University of California San Francisco, San Francisco, California, USA
| | - Romain Bourcier
- Neuroradiologie Diagnostique et Interventionnelle, Hôpital Guillaume & René Laennec, CHU Nantes, Nantes, France
| | - Romain Guile
- Neuroradiologie Diagnostique et Interventionnelle, Hôpital Guillaume & René Laennec, CHU Nantes, Nantes, France
| | - Melanie Walker
- Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Malveeka Sharma
- Neurology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Don Frei
- Radiology, Swedish Medical Center, Englewood, Colorado, USA
| | - Pascal Jabbour
- Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Nabeel Herial
- Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Fawaz Al-Mufti
- Neurology, Neurosurgery, Westchester Medical Center Health Network, Valhalla, New York, USA
| | - Atilla Ozcan Ozdemir
- Stroke and Neurointervention Unit, Eskisehir OsmangaziUniversity, Eskisehir, Turkey
| | - Ozlem Aykac
- Stroke and Neurointervention Unit, Eskisehir OsmangaziUniversity, Eskisehir, Turkey
| | - Dheeraj Gandhi
- Radiology, Neurology, Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Chandril Chugh
- Interventional Neurology, MAX Superspecialty Hospital, Saket, New Delhi, India
| | - Charles Matouk
- Neurosurgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Pascale Lavoie
- Neurosurgery, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, Quebec, Canada
| | - Randall Edgell
- Neurology, St Louis University School of Medicine, St Louis, Missouri, USA
| | - Andre Beer-Furlan
- Neurological Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Michael Chen
- Neurological Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Monika Killer-Oberpfalzer
- Neurology, Research Institute of Neurointervention, University Hospital Salzburg /Paracelsus Medical University, Salzburg, Austria
| | - Vitor Mendes Pereira
- Neurosurgery, Medical Imaging, Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Patrick Nicholson
- Neurosurgery, Medical Imaging, Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Vikram Huded
- Neurology, NH Mazumdar Shah Medical Center, Bangalore, India
| | - Nobuyuki Ohara
- Neurology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Daisuke Watanabe
- Stroke and Neurovascular Surgery, IMS Tokyo-Katsushika General Hospital, Tokyo, Japan
| | - Dong Hun Shin
- Gachon University, Seongnam, Korea (the Republic of)
| | - Pedro Sc Magalhaes
- Stroke Unit, Hospital Municipal Sao Jose, Joinville, Santa Catarina, Brazil
| | - Raghid Kikano
- Interventional Neuroradiology, Lau Medical Center, Beirut, Lebanon
| | | | - Mudassir Farooqui
- Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Amal Abou-Hamden
- Neurosurgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Tatsuo Amano
- Stroke and Cerebrovascular Medicine, Kyorin University, Mitaka, Tokyo, Japan
| | - Ryoo Yamamoto
- Neurology, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Adrienne Weeks
- Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Elena A Cora
- Radiology, QEII Health Sciences Centre, Dalhousie University, Dalhousie, Nova Scotia, Canada
| | | | - Roberto Crosa
- Centro Endovascular Neurologico Medica Uruguaya, Montevideo, Uruguay
| | - Markus Möhlenbruch
- Neuroradiology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Simon Nagel
- Neurology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Hosam Al-Jehani
- Neurosurgery, Interventional Radiology and Critical Care Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Alkhobar, Saudi Arabia
| | - Sunil A Sheth
- Neurology, University of Texas McGovern Medical School, Houston, Texas, USA
| | | | - James E Siegler
- Neurology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | | | - Ajit S Puri
- Neurointerventional Radiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Anna Luisa Kuhn
- Neurointerventional Radiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Gianmarco Bernava
- Interventional Neuroradiology, University Hospitals Geneva, Geneva, Switzerland
| | - Paolo Machi
- Interventional Neuroradiology, University Hospitals Geneva, Geneva, Switzerland
| | - Daniel G Abud
- Interventional Neuroradiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Octavio M Pontes-Neto
- Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Ajay K Wakhloo
- Interventional Neuroradiology, Beth Israel Lahey Health, Burlington, Massachusetts, USA
| | - Barbara Voetsch
- Neurology, Beth Israel Lahey Health, Burlington, Massachusetts, USA
| | - Eytan Raz
- Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Shadi Yaghi
- Neurology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Brijesh P Mehta
- Memorial Neuroscience Institute, Pembroke Pines, Florida, USA
| | - Naoto Kimura
- Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan
| | | | - Jin Soo Lee
- Ajou University Hospital, Suwon, Gyeonggi-do, South Korea
| | - Ji Man Hong
- Ajou University Hospital, Suwon, Gyeonggi-do, South Korea
| | - Robert Fahed
- Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | - Gregory Walker
- Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | - Eiji Hagashi
- Cerebrovascular Medicine, Saga-ken Medical Centre Koseikan, Saga, Japan
| | - Steve M Cordina
- Neurology, Neurosurgery, Radiology, University of South Alabama, Mobile, Alabama, USA
| | - Hong Gee Roh
- Konkuk University, Gwangjin-gu, Seoul, South Korea
| | - Ken Wong
- Interventional Neuroradiology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Juan F Arenillas
- Neurology, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
| | - Mario Martinez-Galdamez
- Interventional Neuroradiology, Hospital Clínico Universitario, Universidad de Valladolid, Valladolid, Spain
| | - Jordi Blasco
- INR, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | | | - Luisa Fonseca
- Stroke Unit, Department of Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M Luis Silva
- Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Teddy Y Wu
- Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - Simon John
- Neurosurgery, Christchurch Hospital, Christchurch, New Zealand
| | - Alex Brehm
- Interventional and Diagnostic Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Marios Psychogios
- Interventional and Diagnostic Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - William J Mack
- Neurosurgery, University of Southern California, Los Angeles, California, USA
| | - Matthew Tenser
- Neurosurgery, University of Southern California, Los Angeles, California, USA
| | - Tatemi Todaka
- Neurosurgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Kumamoto, Japan
| | - Miki Fujimura
- Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan
| | | | - Jun Deguchi
- Endovascular Neurosurgery, Nara City Hospital, Nara, Nara, Japan
| | - Yuri Sugiura
- Neurology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
| | - Hiroshi Tokimura
- Neurosurgery and Stroke Center, Kagoshima City Hospital, Kagoshima, Kagoshima, Japan
| | | | - Michael Kelly
- Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lissa Peeling
- Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Yuichi Murayama
- Neurosurgery, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | | | - Johnny Wong
- Neurosurgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Mohamed Teleb
- Neurosciences, Banner Desert Medical Center, Mesa, Arizona, USA
| | - Jeremy Payne
- Neurosciences, Banner Desert Medical Center, Mesa, Arizona, USA
| | - Hiroki Fukuda
- Neurology, Japanese Red Cross Matsue Hospital, Shimane, Japan
| | - Kosuke Miyake
- Neurology, Shiroyama Hospital, Habikino, Osaka, Japan
| | - Junsuke Shimbo
- Cerebrovascular Medicine, Niigata City General Hospital, Niigata, Niigata, Japan
| | | | - Masaaki Uno
- Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Japan
| | | | - Yuji Matsumaru
- Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Satoshi Yamada
- Neurology, Stroke Center and Neuroendovascular Therapy, Saiseikai Central Hospital, Minato-ku, Tokyo, Japan
| | - Ryuhei Kono
- Neurology, Kinikyo Chuo Hospital, Sapporo, Hokkaido, Japan
| | - Takuya Kanamaru
- Cerebrovascular Medicine, NTT Medical Center Tokyo, Tokyo, Japan
| | - Masafumi Morimoto
- Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan
| | - Junichi Iida
- Neurosurgery, Osaka General Medical Center, Osaka, Japan
| | - Vasu Saini
- Neurology, Neurosurgery, University of Miami School of Medicine, Miami, Florida, USA
| | - Dileep Yavagal
- Neurology, Neurosurgery, University of Miami School of Medicine, Miami, Florida, USA
| | - Saif Bushnaq
- Neurology, Bon Secours Mercy Health System, Toledo, Ohio, USA
| | - Wenguo Huang
- Neurology, Maoming City Hospital, Guandong, China
| | - Italo Linfante
- Interventional Neuroradiology, Endovascular Neurosurgery, Miami Cardiac & Vascular Institute, Miami, Florida, USA
| | - Jawad Kirmani
- Neurology, Hackensack Meridian Health, Edison, New Jersey, USA
| | - David S Liebeskind
- Neurology, University of California Los Angeles, Los Angeles, California, USA
| | - Viktor Szeder
- Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Ruchir Shah
- Neurology, Erlanger Medical Center, University of Tennessee, Chattanooga, Tennessee, USA
| | - Thomas G Devlin
- Neurology, Erlanger Medical Center, University of Tennessee, Chattanooga, Tennessee, USA
| | - Lee Birnbaum
- Neurology, Neurosurgery, Radiology, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Jun Luo
- Neurology, Mianyang 404 Hospital, Mianyang, Sichuan, China
| | | | - Hesham E Masoud
- Neurology, Neurosurgery, Radiology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Carlos Ynigo Lopez
- Neurology, Neurosurgery, Radiology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Brendan Steinfort
- Neurosurgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Alice Ma
- Neurosurgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ameer E Hassan
- Neurosciences, The University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | - Amal Al Hashmi
- Central Stroke Unit, Directorate of Neuroscience, Khoula Hospital, Ministry of Health, Muscat, Oman
| | | | - Maxim Mokin
- Neurosurgery, University of South Florida, Tampa, Florida, USA
| | - Alex Chebl
- Neurology, Henry Ford Health System, Detroit, Michigan, USA
| | | | - Georgios Tsivgoulis
- Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Jane G Morris
- Neurology, Maine Medical Center, Portland, Maine, USA
| | - Clifford J Eskey
- Neuroradiology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Jesse Thon
- Neurology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Leticia Rebello
- Neurology, Hospital Universitario de Brasilia, Brasilia, Distrito Federal, Brazil
| | - Dorothea Altschul
- Neurointerventional Neurosurgery, The Valley Hospital, Ridgewood, New Jersey, USA
| | - Oriana Cornett
- Neurosciences, Stroke Program, St Joseph's University Medical Center, Paterson, New Jersey, USA
| | - Varsha Singh
- Neurosciences, Stroke Program, St Joseph's University Medical Center, Paterson, New Jersey, USA
| | - Jeyaraj Pandian
- Neurology, Christian Medical College and Hospital Ludhiana, Ludhiana, Punjab, India
| | - Anirudh Kulkarni
- Neurology, Christian Medical College and Hospital Ludhiana, Ludhiana, Punjab, India
| | - Pablo M Lavados
- Vascular Neurology Unit, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Veronica V Olavarria
- Vascular Neurology Unit, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Kenichi Todo
- Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuki Yamamoto
- Neurology, Tokushima University Hospital, Tokushima, Japan
| | | | - Serdar Geyik
- Istanbul Aydin University, Istanbul, İstanbul, Turkey
| | - Jasmine Johann
- Radiology, Swedish Medical Center, Englewood, Colorado, USA
| | - Sumeet Multani
- Neurology, Bayhealth Medical Center, Dover, Delaware, USA
| | - Artem Kaliaev
- Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Kazutaka Sonoda
- Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroyuki Hashimoto
- Division of Stroke, Department of Internal Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Adel Alhazzani
- Neurology Division, Department of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
| | - David Y Chung
- Neurology, Boston Medical Center, Boston, Massachusetts, USA
| | - Stephan A Mayer
- Neurology, Neurosurgery, Westchester Medical Center Health Network, Valhalla, New York, USA
| | - Johanna T Fifi
- Neurology, Mount Sinai Health System, New York, New York, USA
| | - Michael D Hill
- Neurology, Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Hao Zhang
- Neurology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhengzhou Yuan
- Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xianjin Shang
- Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China
| | | | - Rishi Gupta
- Neuroscience, WellStar Health System, Marietta, Georgia, USA
| | - Tudor G Jovin
- Neurology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Jean Raymond
- Neuroradiologie Interventionelle, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Osama O Zaidat
- Neurology, Bon Secours Mercy Health System, Toledo, Ohio, USA
| | - Raul G Nogueira
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
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