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Seystahl K, Martinez-Majander N, Salerno A, Beyeler M, Erdur H, Marto JP, Hametner C, Zedde M, Pezzini A, Leker R, Altersberger V, Costamagna G, Serôdio M, Migliaccio L, Pascarella R, Zini A, Mannismäki L, Béjot Y, Jung S, Gensicke H, Padjen V, Ringleb PA, Nolte C, Heldner MR, Michel P, Engelter ST, Curtze S, Weller M, Wegener S. IV Thrombolysis With or Without Endovascular Treatment for Suspected Ischemic Stroke in Patients With Intracranial Tumors. Neurology 2023; 101:e1241-e1255. [PMID: 37463747 PMCID: PMC10516283 DOI: 10.1212/wnl.0000000000207624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/19/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES IV thrombolysis (IVT) for suspected ischemic stroke in patients with intracranial neoplasms is off-label. However, data on risks of intracranial hemorrhage (ICH) are scarce. METHODS In a multicenter registry-based analysis within the European Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration, we assessed frequencies of symptomatic and fatal ICH after IVT for suspected ischemic stroke in patients with intracranial tumors by descriptive statistics and analyzed associations with clinical and imaging characteristics by binary logistic regression. Definition of symptomatic ICH was based on the clinical criteria of the European Cooperative Acute Stroke-II trial including hemorrhage at any site in cranial imaging and concurrent clinical deterioration. RESULTS Screening data of 21,289 patients from 14 centers, we identified 105 patients receiving IVT; among them were 29 patients (28%) with additional endovascular treatment, with suspected, that is, imaging-based, or histologically confirmed diagnosis of intracranial tumors. Among 104 patients with CT or MRI after IVT available, symptomatic and fatal ICH were observed in 9 and 4 patients (9% and 4%, respectively). Among 82 patients with suspected or confirmed meningioma, symptomatic and fatal ICH occurred in 6 and 3 patients (7% and 4%), respectively. In 18 patients with intra-axial suspected or confirmed primary or secondary brain tumors, there was 1 symptomatic nonfatal ICH (6%). Of 4 patients with tumors of the pituitary region, 2 patients (50%) had symptomatic ICH including 1 fatal ICH (25%). Tumor size was not associated with the occurrence of symptomatic ICH (odds ratio 2.8, 95% CI 0.3-24.8, p = 0.34). DISCUSSION In our dataset from routine clinical care, we provide insights on the safety of IVT for suspected ischemic stroke in patients with intracranial tumors, a population that is commonly withheld thrombolysis in clinical practice and prospective trials. Except for a potential high risk of symptomatic ICH after IVT in patients with tumors of the pituitary region, frequencies of symptomatic ICH in patients with intracranial tumors in our cohort seem to be in the upper range of rates observed in previous studies within the TRISP cooperation. These results may guide individual treatment decisions in patients with acute stroke and intracranial tumors with potential benefit of IVT.
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Affiliation(s)
- Katharina Seystahl
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland.
| | - Nicolas Martinez-Majander
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Alexander Salerno
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Morin Beyeler
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Hebun Erdur
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - João Pedro Marto
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Christian Hametner
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Marialuisa Zedde
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Alessandro Pezzini
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Ronen Leker
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Valerian Altersberger
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Gianluca Costamagna
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Miguel Serôdio
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Ludovica Migliaccio
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Rosario Pascarella
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Andrea Zini
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Laura Mannismäki
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Yannick Béjot
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Simon Jung
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Henrik Gensicke
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Visnja Padjen
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Peter A Ringleb
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Christian Nolte
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Mirjam R Heldner
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Patrik Michel
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Stefan T Engelter
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Sami Curtze
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Michael Weller
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Susanne Wegener
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
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Sánchez van Kammen M, Aguiar de Sousa D, Poli S, Cordonnier C, Heldner MR, van de Munckhof A, Krzywicka K, van Haaps T, Ciccone A, Middeldorp S, Levi MM, Kremer Hovinga JA, Silvis S, Hiltunen S, Mansour M, Arauz A, Barboza MA, Field TS, Tsivgoulis G, Nagel S, Lindgren E, Tatlisumak T, Jood K, Putaala J, Ferro JM, Arnold M, Coutinho JM, Sharma AR, Elkady A, Negro A, Günther A, Gutschalk A, Schönenberger S, Buture A, Murphy S, Paiva Nunes A, Tiede A, Puthuppallil Philip A, Mengel A, Medina A, Hellström Vogel Å, Tawa A, Aujayeb A, Casolla B, Buck B, Zanferrari C, Garcia-Esperon C, Vayne C, Legault C, Pfrepper C, Tracol C, Soriano C, Guisado-Alonso D, Bougon D, Zimatore DS, Michalski D, Blacquiere D, Johansson E, Cuadrado-Godia E, De Maistre E, Carrera E, Vuillier F, Bonneville F, Giammello F, Bode FJ, Zimmerman J, d'Onofrio F, Grillo F, Cotton F, Caparros F, Puy L, Maier F, Gulli G, Frisullo G, Polkinghorne G, Franchineau G, Cangür H, Katzberg H, Sibon I, Baharoglu I, Brar J, Payen JF, Burrow J, Fernandes J, Schouten J, Althaus K, Garambois K, Derex L, Humbertjean L, Lebrato Hernandez L, Kellermair L, Morin Martin M, Petruzzellis M, Cotelli M, Dubois MC, Carvalho M, Wittstock M, Miranda M, Skjelland M, Bandettini di Poggio M, Scholz MJ, Raposo N, Kahnis R, Kruyt N, Huet O, Sharma P, Candelaresi P, Reiner P, Vieira R, Acampora R, Kern R, Leker R, Coutts S, Bal S, Sharma SS, Susen S, Cox T, Geeraerts T, Gattringer T, Bartsch T, Kleinig TJ, Dizonno V, Arslan Y. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia. JAMA Neurol 2021; 78:1314-1323. [PMID: 34581763 DOI: 10.1001/jamaneurol.2021.3619] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, Setting, and Participants This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main Outcomes and Measures Clinical characteristics and mortality rate. Results Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.0-7.4), respectively. The mortality rate was 61% (14 of 23) among patients in the TTS group diagnosed before the condition garnered attention in the scientific community and 42% (22 of 53) among patients diagnosed later. Conclusions and Relevance In this cohort study of patients with CVST, a distinct clinical profile and high mortality rate was observed in patients meeting criteria for TTS after SARS-CoV-2 vaccination.
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Affiliation(s)
- Mayte Sánchez van Kammen
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Diana Aguiar de Sousa
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, University of Lisbon, Lisbon, Portugal
| | - Sven Poli
- Department of Neurology and Stroke, Eberhard-Karls University, Tuebingen, Germany.,Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany
| | - Charlotte Cordonnier
- Department of Neurosciences and Cognition, Lille University Hospital, Lille, France
| | - Mirjam R Heldner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anita van de Munckhof
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Katarzyna Krzywicka
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Thijs van Haaps
- Department of Internal Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Alfonso Ciccone
- Department of Neurology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy
| | - Saskia Middeldorp
- Department of Internal Medicine, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marcel M Levi
- National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Johanna A Kremer Hovinga
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Suzanne Silvis
- Department of Neurology, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Sini Hiltunen
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Maryam Mansour
- Sina Hospital, Hamadan University of Medical Science, Hamadan, Iran
| | - Antonio Arauz
- National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico
| | - Miguel A Barboza
- Neurosciences Department, Hospital Dr R.A. Calderón Guardia, San José, Costa Rica
| | - Thalia S Field
- Division of Neurology, University of British Columbia, Vancouver Stroke Program, Vancouver, British Columbia, Canada
| | - Georgios Tsivgoulis
- Second Department of Neurology in National, Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Simon Nagel
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Erik Lindgren
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Turgut Tatlisumak
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jukka Putaala
- Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jose M Ferro
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, University of Lisbon, Lisbon, Portugal
| | - Marcel Arnold
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jonathan M Coutinho
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Aarti R Sharma
- Imperial College London School of Medicine, Imperial College London, London, United Kingdom
| | - Ahmed Elkady
- Department of Neurology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Alberto Negro
- Department of Neuroradiology, Ospedale del Mare, Naples, Italy
| | - Albrecht Günther
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Alexander Gutschalk
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Alina Buture
- Acute Stroke Service, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sean Murphy
- Acute Stroke Service, Mater Misericordiae University Hospital, Dublin, Ireland.,UCD School of Medicine, University College Dublin, Dublin, Ireland.,School of Medicine, University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ana Paiva Nunes
- Department of Neurology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Andreas Tiede
- Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | | | - Annerose Mengel
- Department of Neurology and Stroke, University Hospital Tuebingen, Tuebingen, Germany
| | - Antonio Medina
- Department of Neurology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Audrey Tawa
- Department of Anesthesia and Intensive Care, University Hospital of Rennes, Rennes, France
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, Cramlington, United Kingdom
| | - Barbara Casolla
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, Cramlington, United Kingdom.,Stroke Unit, Hôpital Pasteur 2, URRIS - UR2CA, Unité de Recherche Clinique Cote d'Azur, Cote d'Azur University, Nice, France
| | - Brian Buck
- Division of Neurology, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Carla Zanferrari
- Department of Neurology, Azienda Ospedaliera di Melegnano e della Martesana, Melegnano, Italy
| | | | - Caroline Vayne
- Department of Hematology and Hemostasis, Tours University Hospital, Tours, France
| | - Catherine Legault
- Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Christian Pfrepper
- Division of Hemostaseology, Leipzig University Hospital, Leipzig, Germany
| | | | - Cristina Soriano
- Department of Neurology, Hospital General de Castellón, Castelló, Spain
| | | | - David Bougon
- Department of Critical Care, Annecy Genevois Hospital, Annecy, France
| | | | - Dominik Michalski
- Department of Neurology, Leipzig University Hospital, Leipzig, Germany
| | - Dylan Blacquiere
- Division of Neurology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Elias Johansson
- Department Clinical Science, Wallenberg Center for Molecular Medicine, Umeå University, Umeå, Sweden
| | | | | | - Emmanuel Carrera
- Department of Neurology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | | | - Fabrice Bonneville
- Department of Neuroradiology, Toulouse University Hospital, Toulouse, France
| | - Fabrizio Giammello
- Translational Molecular Medicine and Surgery, XXXV Cycle, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Felix J Bode
- Department of Neurology, Universitätsklinikum Bonn, Bonn, Germany
| | - Julian Zimmerman
- Department of Neurology, Universitätsklinikum Bonn, Bonn, Germany
| | | | - Francesco Grillo
- Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy
| | - Francois Cotton
- Department of Radiology, Lyon University Hospital, Lyon, France
| | - François Caparros
- Department of Neurosciences and Cognition, Lille University Hospital, Lille, France
| | - Laurent Puy
- Department of Neurosciences and Cognition, Lille University Hospital, Lille, France
| | - Frank Maier
- Department of Neurology, Caritas Hospital Saarbrücken, Saarbrücken, Germany
| | - Giosue Gulli
- Department of Medicine, Ashford and St Peters Hospital NHS Foundation Trust, Surrey, United Kingdom
| | - Giovanni Frisullo
- Department of Neurology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Guillaume Franchineau
- Department of Intensive Care, Centre Hospitalier Intercommunal de Poissy Saint Germain en Laye, Poissy, France
| | - Hakan Cangür
- Department of Neurology, Hospital of the City of Wolfsburg, Wolfsburg, Germany
| | - Hans Katzberg
- Department of Neuromuscular Medicine, Toronto General Hospital, Toronto, Ontario, Canada
| | - Igor Sibon
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - Irem Baharoglu
- Department of Neurology, Haga Hospital, The Hague, the Netherlands
| | - Jaskiran Brar
- Department of Neurology, Surrey Memorial Hospital, Surrey, British Columbia, Canada
| | | | - Jim Burrow
- Department of Neurology, Royal Darwin Hospital, Tiwi, Australia
| | - João Fernandes
- Department of Neurology, Norra Älvsborgs Länssjukhus, Trollhattan, Sweden
| | - Judith Schouten
- Department of Neurology, Rijnstate Hospital Arnhem, Arnhem, the Netherlands
| | | | - Katia Garambois
- Stroke Unit, University Hospital of Grenoble, Grenoble, France
| | - Laurent Derex
- Department of Neurology, Hospices Civils de Lyon, Lyon, France
| | | | | | - Lukas Kellermair
- Department of Neurology, Johannes Kepler University Linz, Linz, Austria
| | - Mar Morin Martin
- Department of Neurology, Hospital Complex of Toledo, Toledo, Spain
| | - Marco Petruzzellis
- Department of Neurology, AOU Consorziale Policlinico di Bari, Bari, Italy
| | - Maria Cotelli
- Department of Neurology, ASL Vallecamonica-Sebino, Breno, Italy
| | - Marie-Cécile Dubois
- Department of Anesthesia and Intensive Care, University Hospital of Poitiers, Poitiers, France
| | - Marta Carvalho
- Department of Neurology, Centro Hospitalar Universitário de São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Miguel Miranda
- Department of Neurology, Hospital de Cascais Dr José de Almeida, Cascais, Portugal
| | - Mona Skjelland
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | | | - Moritz J Scholz
- Department of Neurology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
| | - Nicolas Raposo
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - Robert Kahnis
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - Nyika Kruyt
- Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Olivier Huet
- UFR de Bio-médecine, Hospital de la Cavale Blanche, CHRU de Brest, Brest, France
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, United Kingdom
| | - Paolo Candelaresi
- Department of Neurology and Stroke, Cardarelli Hospital, Naples, Italy
| | - Peggy Reiner
- Department of Neurology, Lariboisière Hospital, Paris, France
| | - Ricardo Vieira
- Department of Hematology, Universidade Federal do Cariri, Juazeiro do Norte, Brazil
| | | | - Rolf Kern
- Department of Neurology, Kempten Hospital, Kempten, Germany
| | - Ronen Leker
- Department of Neurology, Hadassah University Medical Center, Jerusalem, Israel
| | - Shelagh Coutts
- Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Simerpreet Bal
- Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Shyam S Sharma
- Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Sophie Susen
- Department of Hematology and Transfusion, Lille University Hospital, Lille, France
| | - Thomas Cox
- Department of Neurology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Thomas Geeraerts
- Department of Anesthesiology and Critical Care, Toulouse University Hospital, Toulouse, France
| | | | - Thorsten Bartsch
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Timothy J Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, Australia
| | - Vanessa Dizonno
- Division of Neurology, University of British Columbia, Vancouver Stroke Program, Vancouver, British Columbia, Canada
| | - Yildiz Arslan
- Neurology Clinic, Medicana İzmir International Hospital, Izmir, Turkey
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