September 19, 2023; 101 (12) Research Article
IV Thrombolysis With or Without Endovascular Treatment for Suspected Ischemic Stroke in Patients With Intracranial Tumors
View ORCID ProfileKatharina Seystahl, Nicolas Martinez-Majander, View ORCID ProfileAlexander Salerno, Morin Beyeler, Hebun Erdur, View ORCID ProfileJoão Pedro Marto, View ORCID ProfileChristian Hametner, View ORCID ProfileMarialuisa Zedde, View ORCID ProfileAlessandro Pezzini, View ORCID ProfileRonen Leker, View ORCID ProfileValerian Altersberger, View ORCID ProfileGianluca Costamagna, Miguel Serôdio, Ludovica Migliaccio, View ORCID ProfileRosario Pascarella, Andrea Zini, Laura Mannismäki, View ORCID ProfileYannick Béjot, Simon Jung, View ORCID ProfileHenrik Gensicke, Visnja Padjen, Peter A. Ringleb, View ORCID ProfileChristian Nolte, View ORCID ProfileMirjam R. Heldner, Patrik Michel, View ORCID ProfileStefan T. Engelter, View ORCID ProfileSami Curtze, Michael Weller, View ORCID ProfileSusanne Wegener
First published July 18, 2023, DOI: https://doi.org/10.1212/WNL.0000000000207624
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.
MDNicolas 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.
MD, PhD, MScAlexander 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.
MDMorin 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.
MDHebun 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.
MDJoão 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.
MDChristian 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.
MDMarialuisa 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.
MDAlessandro 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.
MDRonen 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.
MDValerian 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.
MDGianluca 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.
MDMiguel 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.
MDLudovica 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.
MDRosario 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.
MDAndrea 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.
MDYannick 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.
Prof, MD, PhDSimon 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.
MDHenrik 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.
MDVisnja 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.
MD, PhDPeter 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.
MDChristian 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.
MDMirjam 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.
MD, MScPatrik 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.
MDStefan 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.
MD, MScSami 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.
MD, PhD, MScMichael 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.
MDSusanne 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.
MDIV Thrombolysis With or Without Endovascular Treatment for Suspected Ischemic Stroke in Patients With Intracranial Tumors
Katharina Seystahl, Nicolas Martinez-Majander, Alexander Salerno, Morin Beyeler, Hebun Erdur, João Pedro Marto, Christian Hametner, Marialuisa Zedde, Alessandro Pezzini, Ronen Leker, Valerian Altersberger, Gianluca Costamagna, Miguel Serôdio, Ludovica Migliaccio, Rosario Pascarella, Andrea Zini, Laura Mannismäki, Yannick Béjot, Simon Jung, Henrik Gensicke, Visnja Padjen, Peter A. Ringleb, Christian Nolte, Mirjam R. Heldner, Patrik Michel, Stefan T. Engelter, Sami Curtze, Michael Weller, Susanne Wegener
Neurology Sep 2023, 101 (12) e1241-e1255; DOI: 10.1212/WNL.0000000000207624
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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.
Glossary
- EVT=
- endovascular treatment;
- IAT=
- intraarterial thrombolysis;
- ICH=
- intracranial hemorrhage;
- INR=
- international normalized ratio;
- IVT=
- IV thrombolysis;
- mRS=
- modified Rankin scale;
- NIHSS=
- NIH Stroke scale;
- SWI=
- susceptibility-weighted imaging;
- TRISP=
- Thrombolysis in Ischemic Stroke Patients;
- WHO=
- World Health Organization
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Editor-in-Chief José G. Merino, MD, MPhil, FAHA, FAAN.
- Received February 7, 2023.
- Accepted in final form May 19, 2023.
- © 2023 American Academy of Neurology
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