5
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Minnerup J, Wersching H, Teuber A, Wellmann J, Eyding J, Weber R, Reimann G, Weber W, Krause LU, Kurth T, Berger K, Homberg V, Petrovitch A, Heuser L, Mönnigs P, Krogias C, Wallner B, Hennigs S, Ahlers A, Sahl H, Ranft A, Dobis C, Brassel F, Nolden-Koch M, Schmitt H, Chapot R, Nordmeyer H, Schlamann M, Weimar C, Busch F, Busch E, Sigges E, Ruf H, Wohlfahrt K, Karatschai R, Klein B, Höhle T, Haass A, Nasreldein A, Büchele B, Gahn G, Sterker M, Hantel T, Krämer C, Henningsen H, Adelt I, König M, Schmidt C, Hofmann A, Niederstadt T, Unrath M, Rehfeldt T, Fauser B, Pfeiffer A, Lowens S, Stögbauer F, Staudacher T, Erdmann P, Grotemeyer K, Spüntrup E, Bücke P, Wienecke P, Faiss J, Wolzik-Großmann M, Brune N, Isenmann S, Thomas C, Mucha D. Outcome After Thrombectomy and Intravenous Thrombolysis in Patients With Acute Ischemic Stroke. Stroke 2016; 47:1584-92. [DOI: 10.1161/strokeaha.116.012619] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/28/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
In patients with ischemic stroke, randomized trials showed a better functional outcome after endovascular therapy with new-generation thrombectomy devices compared with medical treatment, including intravenous thrombolysis. However, effects on mortality and the generalizability of results to routine clinical practice are uncertain.
Methods—
In a prospective observational register-based study patients with ischemic stroke treated either with thrombectomy, intravenous thrombolysis, or their combination were included. Primary outcome was the modified Rankin scale score (0 [no symptoms] to 6 [death]) at 3 months. Ordinal logistic regression was used to estimate the common odds ratio as treatment effects (shift analysis). Propensity score matching was applied to compare patients treated either with intravenous thrombolysis alone or with intravenous thrombolysis plus thrombectomy.
Results—
Among 2650 recruited patients, 1543 received intravenous thrombolysis, 504 underwent thrombectomy, and 603 received intravenous thrombolysis in combination with thrombectomy. Later time-to-treatment was associated with worse outcomes among patients treated with thrombectomy plus thrombolysis. In 241 pairs of propensity score–matched patients with a proximal intracranial occlusion, thrombectomy plus thrombolysis was associated with improved functional outcome (common odds ratio, 1.84; 95% confidence interval, 1.32–2.57), and reduced mortality (15% versus 33%;
P
<0.0001) compared with intravenous thrombolysis alone. Results were similar in various sensitivity analyses accounting for missing outcome data and different analytic methods.
Conclusions—
Results from this large prospective registry show that also in routine clinical care thrombectomy plus thrombolysis compared with thrombolysis alone improved functional outcome and reduced mortality in patients with ischemic stroke. Earlier treatment was associated with better outcomes.
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Affiliation(s)
- Jens Minnerup
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Heike Wersching
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Anja Teuber
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Jürgen Wellmann
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Jens Eyding
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Ralph Weber
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Gernot Reimann
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Werner Weber
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Lars Udo Krause
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Tobias Kurth
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
| | - Klaus Berger
- From the Department of Neurology (J.M.) and Institute of Epidemiology and Social Medicine (H.W., A.T., J.W., K.B.), University of Münster, Münster, Germany; Department of Neurology (J.E.) and Institute of Radiology, Neuroradiology, and Nuclear Medicine (W.W.), University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany (R.W.); Department of Neurology, Städtisches Klinikum Dortmund, Dortmund, Germany
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- Universitätsklinikum Homburg/Saar
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6
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Rolfs A, Fazekas F, Grittner U, Dichgans M, Martus P, Holzhausen M, Böttcher T, Heuschmann PU, Tatlisumak T, Tanislav C, Jungehulsing GJ, Giese AK, Putaala J, Huber R, Bodechtel U, Lichy C, Enzinger C, Schmidt R, Hennerici MG, Kaps M, Kessler C, Lackner K, Paschke E, Meyer W, Mascher H, Riess O, Kolodny E, Norrving B, Rolfs A, Ginsberg M, Hennerici MG, Kessler C, Kolodny E, Martus P, Norrving B, Ringelstein EB, Rothwell PM, Venables G, Bornstein N, deDeyn P, Dichgans M, Fazekas F, Markus H, Rieß O, Biedermann C, Böttcher T, Brüderlein K, Burmeister J, Federow I, König F, Makowei G, Niemann D, Rolfs A, Rösner S, Zielke S, Grittner U, Martus P, Holzhausen M, Fazekas F, Enzinger C, Schmidt R, Ropele S, Windisch M, Sterner E, Bodamer O, Fellgiebel A, Hillen U, Jonas L, Kampmann C, Kropp P, Lackner K, Laue M, Mascher H, Meyer W, Paschke E, Weidemann F, Berrouschot J, Stoll A, Rokicha A, Sternitzky C, Thomä M, DeDeyn PP, Sheorajpanday R, De Brabander I, Yperzeele L, Brouns R, Oschmann P, Pott M, Schultes K, Schultze C, Hirsekorn J, Jungehulsing GJ, Villringer A, Schmidt W, Liman T, Nowe T, Ebinger M, Wille A, Loui H, Objartel A, übelacker A, Mette R, Jegzentis K, Nabavi DG, Crome O, Bahr D, Ebke M, Platte B, Kleinen C, Mermolja Gunther K, Heide W, Pape O, Hanssen JR, Stangenberg D, Klingelhofer J, Schmidt B, Schwarz S, Schwarze J, Frandlih L, Iwanow J, Steinbach I, Krieger D, Boysen G, Leth Jeppesen L, Petersen A, Reichmann H, Becker U, Dzialkowski I, Hentschel H, Lautenschlager C, Hanso H, Gahn G, Ziemssen T, Fleischer K, Sehr B, McCabe DJH, Tobin O, Kinsella J, Murphy RP, Jander S, Hartung HP, Siebler M, Bottcher C, Kohne A, Platzen J, Brosig TC, Rothhammer V, Henseler C, Neumann-Haefelin T, Singer OC, Ermis U, dos Santos IMRM, Schuhmann C, van de Loo S, Kaps M, Allendorfer J, Tanislav C, Brandtner M, Muir K, Dani K, MacDougall N, Smith W, Rowe A, Welch A, Fazekas F, Schrotter G, Krenn U, Horner S, Pendl B, Pluta-Fuerst A, Trummer U, Kessler C, Chatzopoulos M, v Sarnowski B, Schminke U, Link T, Khaw A, Nieber E, Zierz S, Muller T, Wegener N, Wartenberg K, Gaul C, Richter D, Rosenkranz M, Krützelmann AC, Hoppe J, Choe CU, Narr S, Magnus TU, Thomalla G, Leypoldt F, Otto D, Lichy C, Hacke W, Barrows RJ, Tatlisumak T, Putaala J, Curtze S, Metso M, Willeit J, Furtner M, Spiegel M, Knoflach MH, Prantl B, Witte OW, Brämer D, Günther A, Prell T, Herzau C, Aurich K, Deuschl G, Wodarg F, Zimmermann P, Eschenfelder CC, Levsen M, Weber JR, Marecek SM, Schneider D, Michalski D, Kloppig W, Küppers-Tiedt L, Schneider M, Schulz A, Matzen P, Weise C, Hobohm C, Meier H, Langos R, Urban D, Gerhardt I, Thijs V, Lemmens R, Marcelis E, Hulsbosch C, Aichner F, Haring HP, Bach E, Machado Candido J, e Silva AA, Lourenco M, de Sousa AIM, Derex L, Cho TH, Díez-Tejedor E, Fuentes B, Martínez-Sanchez P, Pérez-Guevara MI, Hamer H, Metz A, Hallenberger K, Müller P, Baron P, Bersano A, Gattinoni M, Vella N, Mallia M, Jauss M, Adam L, Heidler F, Gube C, Kiszka M, Dichgans M, Karpinska A, Mewald Y, Straub V, Dörr A, Zollver A, Ringelstein EB, Schilling M, Borchert A, Preuth N, Duning T, Kuhlenbäumer G, Schulte D, Rothwell PM, Marquardt L, Schlachetzki F, Boy S, Mädl J, Ertl GM, Fehm NPR, Stadler C, Benecke R, Dudesek A, Kolbaske S, Lardurner G, Sulzer C, Zerbs A, Lilek S, Walleczek AM, Sinadinowska D, Janelidze M, Beridze M, Lobjanidze N, Dzagnidze A, Melms A, Horber K, Fink I, Liske B, Ludolph AC, Huber R, Knauer K, Hendrich C, Raubold S, Czlonkowska A, Baranowska A, Blazejewska-Hyzorek B, Lang W, Kristoferitsch W, Ferrari J, Ulrich E, Flamm-Horak A, Lischka-Lindner A, Schreiber W, Demarin V, Tranjec Z, Bosner-Puretic M, Jurašić MJ, Basic Kes V, Budisic M, Kopacevic L. Acute Cerebrovascular Disease in the Young. Stroke 2013; 44:340-9. [PMID: 23306324 DOI: 10.1161/strokeaha.112.663708] [Citation(s) in RCA: 150] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients.
Methods—
Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers between April 2007 and January 2010 undergoing a detailed, standardized, clinical, laboratory, and radiological protocol.
Results—
Median age in the overall cohort was 46 years. Definite Fabry disease was diagnosed in 0.5% (95% confidence interval, 0.4%–0.8%; n=27) of all patients; and probable Fabry disease in additional 18 patients. Males dominated the study population (2962/59%) whereas females outnumbered men (65.3%) among the youngest patients (18–24 years). About 80.5% of the patients had a first stroke. Silent infarcts on magnetic resonance imaging were seen in 20% of patients with a first-ever stroke, and in 11.4% of patients with transient ischemic attack and no history of a previous cerebrovascular event. The most common causes of ischemic stroke were large artery atherosclerosis (18.6%) and dissection (9.9%).
Conclusions—
Definite Fabry disease occurs in 0.5% and probable Fabry disease in further 0.4% of young stroke patients. Silent infarcts, white matter intensities, and classical risk factors were highly prevalent, emphasizing the need for new early preventive strategies.
Clinical Trial Registration Information—
URL:
http://www.clinicaltrials.gov
.Unique identifier: NCT00414583
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Affiliation(s)
- Arndt Rolfs
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Franz Fazekas
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Ulrike Grittner
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Martin Dichgans
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Peter Martus
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Martin Holzhausen
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Tobias Böttcher
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Peter U. Heuschmann
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Turgut Tatlisumak
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christian Tanislav
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Gerhard J. Jungehulsing
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Anne-Katrin Giese
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Jukaa Putaala
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Roman Huber
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Ulf Bodechtel
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christoph Lichy
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christian Enzinger
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Reinhold Schmidt
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Michael G. Hennerici
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Manfred Kaps
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christof Kessler
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Karl Lackner
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Eduard Paschke
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Wolfgang Meyer
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Hermann Mascher
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Olaf Riess
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Edwin Kolodny
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Bo Norrving
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - A Rolfs
- University of Rostock, Rostock, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - I Federow
- University of Rostock, Rostock, Germany
| | - F König
- University of Rostock, Rostock, Germany
| | - G Makowei
- University of Rostock, Rostock, Germany
| | - D Niemann
- University of Rostock, Rostock, Germany
| | - A Rolfs
- University of Rostock, Rostock, Germany
| | - S Rösner
- University of Rostock, Rostock, Germany
| | - S Zielke
- University of Rostock, Rostock, Germany
| | - U Grittner
- Department of Biostatistics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Germany
| | - P Martus
- Department of Biostatistics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Germany
| | - M Holzhausen
- Department of Biostatistics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Germany
| | - F Fazekas
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | - C Enzinger
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | - R Schmidt
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | - S Ropele
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | | | | | | | | | - U Hillen
- (Essen, Germany) immunohistochemistry
| | - L Jonas
- (Rostock, Germany) electron-microscopy
| | | | - P Kropp
- (Rostock, Germany) headache and pain
| | | | - M Laue
- (Rostock, Germany) electron-microscopy
| | | | - W Meyer
- (London) epidemiology and neuropsychiatry
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - W Schmidt
- Berlin – Charite/Germany, University
| | - T Liman
- Berlin – Charite/Germany, University
| | - T Nowe
- Berlin – Charite/Germany, University
| | - M Ebinger
- Berlin – Charite/Germany, University
| | - A Wille
- Berlin – Charite/Germany, University
| | - H Loui
- Berlin – Charite/Germany, University
| | | | | | - R Mette
- Berlin – Charite/Germany, University
| | | | | | | | - D Bahr
- Berlin – Neukolln/Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - G Gahn
- Dresden/Germany, University
| | | | | | - B Sehr
- Dresden/Germany, University
| | | | | | | | | | | | | | | | | | - A Kohne
- Dusseldorf/Germany, University
| | | | | | | | | | | | - OC Singer
- Frankfurt am Main/Germany, University
| | - U Ermis
- Frankfurt am Main/Germany, University
| | | | | | | | - M Kaps
- Giessen/Germany, University
| | | | | | | | - K Muir
- Glasgow/United Kingdom, University
| | - K Dani
- Glasgow/United Kingdom, University
| | | | - W Smith
- Glasgow/United Kingdom, University
| | - A Rowe
- Glasgow/United Kingdom, University
| | - A Welch
- Glasgow/United Kingdom, University
| | | | | | - U Krenn
- Graz/Austria, Medical University
| | - S Horner
- Graz/Austria, Medical University
| | - B Pendl
- Graz/Austria, Medical University
| | | | | | | | | | | | | | - T Link
- Greifswald/Germany, University
| | - A Khaw
- Greifswald/Germany, University
| | | | | | | | | | | | - C Gaul
- Halle/Germany, University
| | | | | | | | | | | | - S Narr
- Hamburg/Germany, University
| | | | | | | | - D Otto
- Hamburg/Germany, University
| | - C Lichy
- Heidelberg/Germany, University
| | - W Hacke
- Heidelberg/Germany, University
| | | | | | | | | | - M Metso
- Helsinki/Finland, University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Metz
- Marburg/Germany, University
| | | | | | | | | | | | | | | | - M Jauss
- Muhlhausen/Thuringen/Germany
| | - L Adam
- Muhlhausen/Thuringen/Germany
| | | | - C Gube
- Muhlhausen/Thuringen/Germany
| | | | | | | | | | | | - A Dörr
- Munich/Germany, University
| | | | | | | | | | | | | | | | | | | | | | | | - S Boy
- Regensburg/Germany, University
| | - J Mädl
- Regensburg/Germany, University
| | - GM Ertl
- Regensburg/Germany, University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Melms
- Tubingen/Germany, University
| | | | - I Fink
- Tubingen/Germany, University
| | - B Liske
- Tubingen/Germany, University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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