Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up

Nguyen TN; Qureshi MM; Klein P; Yamagami H; Mikulik R; Czlonkowska A; Abdalkader M; Sedova P; Sathya A; Lo HC; Mansour OY; Vanguru HR; Lesaine E; Tsivgoulis G; Loochtan AI; Demeestere J; Uchino K; Inoa V; Goyal N; Charidimou A; Siegler JE; Yaghi S; Aguiar de Sousa D; Mohammaden MH; Haussen DC; Kristoffersen ES; Lereis VP; Scollo SD; Campbell BCV; Ma A; Thomas JO; Parsons MW; Singhal S; Slater LA; Tomazini Martins R; Enzinger C; Gattringer T; Rahman A; Bonnet T; Ligot N; De Raedt S; Lemmens R; Vanacker P; Vandervorst F; Conforto AB; Hidalgo RCT; de Oliveira Neves L; Martins RT; Mora Cuervo DL; Rebello LC; Santiago IB; Lameirinhas da Silva I; Sakelarova T; Kalpachki R; Alexiev F; Catanese L; Cora EA; Goyal M; Hill MD; Kelly ME; Khosravani H; Lavoie P; Peeling L; Pikula A; Rivera R; Chen HS; Chen Y; Huo X; Miao Z; Yang S; Bedekovic MR; Bralic M; Budincevic H; Corredor-Quintero AB; Lara-Sarabia OE; Cabal M; Tenora D; Fibrich P; Herzig R; Hlaváčová H; Hrabanovska E; Hlinovsky D; Jurak L; Kadlcikova J; Karpowicz I; Klecka L; Kovar M; Lauer D; Neumann J; Palouskova H; Reiser M; Rekova P; Rohan V; Skoda O; Škorňa M; Sobotková L; Sramek M; Zakova L; Christensen H; Drenck N; Iversen HK; Truelsen TC; Wienecke T; Sobh K; Ylikotila P; Alpay K; Strbian D; Bernady P; Casenave P; Dan M; Faucheux JM; Gentric JC; Magro E; Sabben C; Reiner P; Rouanet F; Bohmann FO; Boskamp S; Mbroh J; Nagel S; Nolte CH; Ringleb PA; Rosenkranz M; Poli S; Thomalla G; Karapanayiotides T; Koutroulou I; Kargiotis O; Palaiodimou L; Barrientos Guerra JD; Huded V; Menon B; Nagendra S; Prajapati C; Sylaja PN; Krishna Pramana NA; Sani AF; Ghoreishi A; Farhoudi M; Hokmabadi ES; Raya TA; Kalmanovich SA; Ronen L; Sabetay SI; Acampa M; Adami A; Castellan L; Longoni M; Ornello R; Renieri L; Bigliani CR; Romoli M; Sacco S; Salmaggi A; Sangalli D; Zini A; Doijiri R; Fukuda H; Fujinaka T; Fujita K; Imamura H; Sakai N; Kanamaru T; Kimura N; Kono R; Miyake K; Sakaguchi M; Sakai K; Sonoda K; Todo K; Miyashita F; Tokuda N; Matsumaru Y; Matsumoto S; Ohara N; Shindo S; Takenobu Y; Yoshimoto T; Toyoda K; Uwatoko T; Yagita Y; Yamada T; Yamamoto N; Yamamoto R; Yazawa Y; Sugiura Y; Waweru PK; Baek JH; Lee SB; Seo KD; Sohn SI; Arsovska AA; Chan YC; Wan Zaidi WA; Jaafar AS; Gongora-Rivera F; Martinez-Marino M; Infante-Valenzuela A; Groppa S; Leahu P; Coutinho JM; Rinkel LA; Dippel DWJ; van Dam-Nolen DHK; Ranta A; Wu TY; Adebayo TT; Bello AH; Nwazor EO; Sunmonu TA; Wahab KW; Ronning OM; Sandset EC; Al Hashmi AM; Ahmad S; Rashid U; Rodriguez-Kadota L; Vences MÁ; Yalung PM; Hao Dy JS; Pineda-Franks MC; Co CO; Brola W; Debiec A; Dorobek M; Karlinski MA; Labuz-Roszak BM; Lasek-Bal A; Sienkiewicz-Jarosz H; Staszewski J; Sobolewski P; Wiacek M; Zielinska-Turek J; Araujo AP; Rocha M; Castro P; Cruz VT; Ferreira PV; Ferreira P; Nunes AP; Fonseca L; Marto JP; Pinho E Melo T; Rodrigues M; Silva ML; Dimitriade A; Falup-Pecurariu C; Hamid MA; Venketasubramanian N; Krastev G; Mako M; Ayo-Martin O; Hernández-Fernández F; Blasco J; Rodríguez-Vázquez A; Cruz-Culebras A; Moniche F; Montaner J; Perez-Sanchez S; García Sánchez MJ; Guillán Rodríguez M; Jood K; Nordanstig A; Mazya MV; Moreira TTP; Bernava G; Beyeler M; Bolognese M; Carrera E; Dobrocky T; Karwacki GM; Keller E; Hsieh CY; Boonyakarnkul S; Churojana A; Aykac O; Ozdemir AÃ; Bajrami A; Senadim S; Hussain SI; John S; Banerjee S; Kwan J; Krishnan K; Lenthall R; Matthews A; Wong K; Zhang L; Altschul D; Asif KS; Bahiru Z; Below K; Biller J; Ruland S; Chaudry SA; Chen M; Chebl A; Cibulka J; Cistrunk L; Clark J; Colasurdo M; Czap A; de Havenon A; D'Amato S; Dharmadhikari S; Grimmett KB; Dmytriw AA; Etherton MR; Ezepue C; Farooqui M; Feske SK; Fink L; Gasimova U; Guzik AK; Hakemi M; Hovingh M; Khan M; Jillela D; Kan PT; Khatri R; Khawaja AM; Khoury NN; Kiley NL; Kim BS; Kolikonda MK; Kuhn AL; Lara S; Linares G; Linfante I; Lukovits TG; Lycan S; Male SS; Maali L; Mancin J; Masoud H; Mohamed GA; Monteiro A; Nahab F; Nalleballe K; Ortega-Gutierrez S; Puri AS; Radaideh Y; Rahangdale RH; Rai A; Ramakrishnan P; Reddy AB; Rojas-Soto DM; Romero JR; Rost NS; Rothstein A; Omran SS; Sheth SA; Siddiqui AH; Starosciak AK; Tarlov NE; Taylor RA; Wang MJ; Wolfe J; Wong KH; Le HV; Nguyen QV; Pham TN; Nguyen TT; Phan HT; Ton MD; Fischer U; Michel P; Strambo D; Martins SO; Zaidat OO; Nogueira RG; and the SVIN COVID-19 Global Stroke Registry

doi:10.1212/WNL.0000000000201426

Fulltext

Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up

Nguyen TN ¹ , Qureshi MM ² , Klein P ² , Yamagami H ² , Mikulik R ² , Czlonkowska A ² Show all authors , Abdalkader M ² , Sedova P ² , Sathya A ² , Lo HC ² , Mansour OY ² , Vanguru HR ² , Lesaine E ² , Tsivgoulis G ² , Loochtan AI ² , Demeestere J ² , Uchino K ² , Inoa V ² , Goyal N ² , Charidimou A ² , Siegler JE ² , Yaghi S ² , Aguiar de Sousa D ² , Mohammaden MH ² , Haussen DC ² , Kristoffersen ES ² , Lereis VP ² , Scollo SD ² , Campbell BCV ² , Ma A ² , Thomas JO ² , Parsons MW ² , Singhal S ² , Slater LA ² , Tomazini Martins R ² , Enzinger C ² , Gattringer T ² , Rahman A ² , Bonnet T ² , Ligot N ² , De Raedt S ² , Lemmens R ² , Vanacker P ² , Vandervorst F ² , Conforto AB ² , Hidalgo RCT ² , de Oliveira Neves L ² , Martins RT ² , Mora Cuervo DL ² , Rebello LC ² , Santiago IB ² , Lameirinhas da Silva I ² , Sakelarova T ² , Kalpachki R ² , Alexiev F ² , Catanese L ² , Cora EA ² , Goyal M ² , Hill MD ² , Kelly ME ² , Khosravani H ² , Lavoie P ² , Peeling L ² , Pikula A ² , Rivera R ² , Chen HS ² , Chen Y ² , Huo X ² , Miao Z ² , Yang S ² , Bedekovic MR ² , Bralic M ² , Budincevic H ² , Corredor-Quintero AB ² , Lara-Sarabia OE ² , Cabal M ² , Tenora D ² , Fibrich P ² , Herzig R ² , Hlaváčová H ² , Hrabanovska E ² , Hlinovsky D ² , Jurak L ² , Kadlcikova J ² , Karpowicz I ² , Klecka L ² , Kovar M ² , Lauer D ² , Neumann J ² , Palouskova H ² , Reiser M ² , Rekova P ² , Rohan V ² , Skoda O ² , Škorňa M ² , Sobotková L ² , Sramek M ² , Zakova L ² , Christensen H ² , Drenck N ² , Iversen HK ² , Truelsen TC ² , Wienecke T ² , Sobh K ² , Ylikotila P ² , Alpay K ² , Strbian D ² , Bernady P ² , Casenave P ² , Dan M ² , Faucheux JM ² , Gentric JC ² , Magro E ² , Sabben C ² , Reiner P ² , Rouanet F ² , Bohmann FO ² , Boskamp S ² , Mbroh J ² , Nagel S ² , Nolte CH ² , Ringleb PA ² , Rosenkranz M ² , Poli S ² , Thomalla G ² , Karapanayiotides T ² , Koutroulou I ² , Kargiotis O ² , Palaiodimou L ² , Barrientos Guerra JD ² , Huded V ² , Menon B ² , Nagendra S ² , Prajapati C ² , Sylaja PN ² , Krishna Pramana NA ² , Sani AF ² , Ghoreishi A ² , Farhoudi M ² , Hokmabadi ES ² , Raya TA ² , Kalmanovich SA ² , Ronen L ² , Sabetay SI ² , Acampa M ² , Adami A ² , Castellan L ² , Longoni M ² , Ornello R ² , Renieri L ² , Bigliani CR ² , Romoli M ² , Sacco S ² , Salmaggi A ² , Sangalli D ² , Zini A ² , Doijiri R ² , Fukuda H ² , Fujinaka T ² , Fujita K ² , Imamura H ² , Sakai N ² , Kanamaru T ² , Kimura N ² , Kono R ² , Miyake K ² , Sakaguchi M ² , Sakai K ² , Sonoda K ² , Todo K ² , Miyashita F ² , Tokuda N ² , Matsumaru Y ² , Matsumoto S ² , Ohara N ² , Shindo S ² , Takenobu Y ² , Yoshimoto T ² , Toyoda K ² , Uwatoko T ² , Yagita Y ² , Yamada T ² , Yamamoto N ² , Yamamoto R ² , Yazawa Y ² , Sugiura Y ² , Waweru PK ² , Baek JH ² , Lee SB ² , Seo KD ² , Sohn SI ² , Arsovska AA ² , Chan YC ² , Wan Zaidi WA ² , Jaafar AS ² , Gongora-Rivera F ² , Martinez-Marino M ² , Infante-Valenzuela A ² , Groppa S ² , Leahu P ² , Coutinho JM ² , Rinkel LA ² , Dippel DWJ ² , van Dam-Nolen DHK ² , Ranta A ² , Wu TY ² , Adebayo TT ² , Bello AH ² , Nwazor EO ² , Sunmonu TA ² , Wahab KW ² , Ronning OM ² , Sandset EC ² , Al Hashmi AM ² , Ahmad S ² , Rashid U ² , Rodriguez-Kadota L ² , Vences MÁ ² , Yalung PM ² , Hao Dy JS ² , Pineda-Franks MC ² , Co CO ² , Brola W ² , Debiec A ² , Dorobek M ² , Karlinski MA ² , Labuz-Roszak BM ² , Lasek-Bal A ² , Sienkiewicz-Jarosz H ² , Staszewski J ² , Sobolewski P ² , Wiacek M ² , Zielinska-Turek J ² , Araujo AP ² , Rocha M ² , Castro P ² , Cruz VT ² , Ferreira PV ² , Ferreira P ² , Nunes AP ² , Fonseca L ² , Marto JP ² , Pinho E Melo T ² , Rodrigues M ² , Silva ML ² , Dimitriade A ² , Falup-Pecurariu C ² , Hamid MA ² , Venketasubramanian N ² , Krastev G ² , Mako M ² , Ayo-Martin O ² , Hernández-Fernández F ² , Blasco J ² , Rodríguez-Vázquez A ² , Cruz-Culebras A ² , Moniche F ² , Montaner J ² , Perez-Sanchez S ² , García Sánchez MJ ² , Guillán Rodríguez M ² , Jood K ² , Nordanstig A ² , Mazya MV ² , Moreira TTP ² , Bernava G ² , Beyeler M ² , Bolognese M ² , Carrera E ² , Dobrocky T ² , Karwacki GM ² , Keller E ² , Hsieh CY ² , Boonyakarnkul S ² , Churojana A ² , Aykac O ² , Ozdemir AÃ ² , Bajrami A ² , Senadim S ² , Hussain SI ² , John S ² , Banerjee S ² , Kwan J ² , Krishnan K ² , Lenthall R ² , Matthews A ² , Wong K ² , Zhang L ² , Altschul D ² , Asif KS ² , Bahiru Z ² , Below K ² , Biller J ² , Ruland S ² , Chaudry SA ² , Chen M ² , Chebl A ² , Cibulka J ² , Cistrunk L ² , Clark J ² , Colasurdo M ² , Czap A ² , de Havenon A ² , D'Amato S ² , Dharmadhikari S ² , Grimmett KB ² , Dmytriw AA ² , Etherton MR ² , Ezepue C ² , Farooqui M ² , Feske SK ² , Fink L ² , Gasimova U ² , Guzik AK ² , Hakemi M ² , Hovingh M ² , Khan M ² , Jillela D ² , Kan PT ² , Khatri R ² , Khawaja AM ² , Khoury NN ² , Kiley NL ² , Kim BS ² , Kolikonda MK ² , Kuhn AL ² , Lara S ² , Linares G ² , Linfante I ² , Lukovits TG ² , Lycan S ² , Male SS ² , Maali L ² , Mancin J ² , Masoud H ² , Mohamed GA ² , Monteiro A ² , Nahab F ² , Nalleballe K ² , Ortega-Gutierrez S ² , Puri AS ² , Radaideh Y ² , Rahangdale RH ² , Rai A ² , Ramakrishnan P ² , Reddy AB ² , Rojas-Soto DM ² , Romero JR ² , Rost NS ² , Rothstein A ² , Omran SS ² , Sheth SA ² , Siddiqui AH ² , Starosciak AK ² , Tarlov NE ² , Taylor RA ² , Wang MJ ² , Wolfe J ² , Wong KH ² , Le HV ² , Nguyen QV ² , Pham TN ² , Nguyen TT ² , Phan HT ² , Ton MD ² , Fischer U ² , Michel P ² , Strambo D ² , Martins SO ² , Zaidat OO ² , Nogueira RG ² , and the SVIN COVID-19 Global Stroke Registry

Affiliations

¹ From the Department of Neurology (T.N.N., P.K., Anvitha Sathya, H.C.L., Andreas Charidimou, Judith Clark, S.K.F., J.R.R.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine; Department of Radiology (T.N.N., M.M.Q., P.K., Mohamad Abdalkader, Anvitha Sathya, H.C.L., N.L.K.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine; Department of Stroke Neurology (H.Y.), National Hospital Organization, Osaka National Hospital, Japan; Department of Neurology (R.M., Petra Sedova), International Clinical Research Centre, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; 2nd Department of Neurology (Anna Czlonkowska, M.A.K.), Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Internal Medicine and Cardiology (Petra Sedova), University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Neurology (O.Y.M.), Alexandria University Stroke and Neurointervention Unit, Egypt; Department of Neurology (H.R.V., K.U.), Cleveland Clinic; Centre Hospitalier de l'Université de Bordeaux (E.L.), INSERM, Bordeaux Population Health Research Center, France; Second Department of Neurology (Georgios Tsivgoulis, Lina Palaiodimou), "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece; Ohio Health Riverside Methodist Hospital (A.I.L.); Neurology Department (J.D., Robin Lemmens), Leuven University Hospital, Belgium; University of Tennessee Health Science Center (V.I., N.G.); Cooper Neurological Institute (J.E.S., J.W.), Cooper University Hospital, Camden, NJ; Department of Neurology (Shadi Yaghi), Rhode Island Hospital, Brown University, Providence; Stroke Center (D.A.S.), Centro Hospitalar Universitário Lisboa Central-CHULC, Portugal, CEEM; Institute of Anatomy (D.A.S.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Neurology (Mahmoud Mohammaden, D.C.H.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Neurology (E.S.K.), Akershus University Hospital, University of Oslo, Norway and Department of General Practice, University of Oslo, Norway; Division de Neurologia Vascular (V.P.L.), Departmento de Neurologia, Institute for Neurological Research-FLENI, Buenos Aires, Argentina; Stroke Unit (S.D.S.), Ramos Mejia Hospital, Buenos Aires, Argentina; Department of Medicine and Neurology (B.C.V.C.), Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Royal North Shore Hospital (Alice Ma), Sydney, Australia; Department of Neurophysiology (J.O.T), Liverpool Hospital, New South Wales, Australia; Department of Neurology (M.W.P.), Liverpool Hospital, New South Wales, Australia; Departments of Neurology (Shaloo Singal) and Radiology (L.-A.S.), Monash Medical Centre, Australia; Stroke and Aging Research Group (Shaloo Singhal), School of Clinical Sciences at Monash Health, Monash University, Australia; Department of Neurology (Rodrigo Tomazini Martins), Mater Hospital, Brisbane, Australia; Department of Neurology (Chris Enzinger), Medical University of Graz, Austria; Department of Neurology and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Medical University of Graz, Austria; Department of Neurology (Aminur Rahman), Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh; Hopital Erasme (T.B., N.L.), Brussels, Belgium; Department of Neurology (S.D.R., F.V.), Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel, Belgium; Department of Neurology (P.V.), University Hospitals Antwerp; Department of Translational Neuroscience (P.V.), University of Antwerp, Belgium; Hospital das Clínicas (A.B.C., I.L.S.), São Paulo University, Brazil; Department of Neurology and Interventional Neuroradiology (R.C.T.H.), Hospital de Base de São José do Rio Preto, São Paulo, Brazil; Department of Neurology (L.O.N., I.B.S.), Hospital São Carlos, Fortaleza, Ceará, Brazil Stroke Unit (Rodrigo Targa Martins), Neurology, Nossa Senhora da Conceição Hospital, Porto Alegre, Brazil; Moinhos de Vento Hospital (D.L.M.C.), Brazil; Hospital de Base do Distrito Federal (L.C.R.), Brasilia, Brazil; St. Anna University Hospital (T.S., Rosen Kalpachki, F.A.), Sofia, Bulgaria; Department of Neurology (Luciana Catanese), McMaster University, Hamilton, Canada; Department of Diagnostic Radiology (E.A.C.), Halifax Infirmary, Dalhousie University, Halifax, Canada; Departments of Clinical Neurosciences and Radiology (M.G., M.D.H.), Hotchkiss Brain Institute, Cummings School of Medicine, University of Calgary, Canada; Royal University Hospital (M.E.K., Lissa Peeling), Saskatoon, Saskatchewan, Canada; Department of Neurology (H.K.), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Division of Neurology, Department of Medicine, University of Toronto, Canada; Hopital Enfant Jesus (Pascale Lavoie), Centre Hospitalier de l'Université Laval, Quebec City, Canada; Toronto Western Hospital (A.P.), University of Toronto, Canada; Neuroradiology Department (R.R.), Instituto de Neurocirugía Dr. Asenjo, Santiago, Chile; Department of Neurology (H.-S.C.), General Hospital of Northern Theater Command, Shen Yang, China; Department of Neurology (Y.C., Shuiquan Yang), Foshan Sanshui District People's Hospital, China; Interventional Neuroradiology (X.H., Z.M.), Beijing Tiantian Hospital, China; Department of Neurology (M.R.B.), Sestre Milosrdnice University Hospital Center, Croatia; Department of Neurology (Marina Bralic), Clinical Hospital Center Rijeka, Croatia; Sveti Duh University Hospital - Zagreb (H.B.), Department of Neurology, Croatia; J.J. Strossmayer University of Osijek (H.B.), Faculty of Medicine, Department of Neurology and Neurosurgery, Osijek, Croatia; Department of Neurology (A.B.C.-Q.), Hospital Departamental Universitario del Quindío San Juan de Dios, Colombia; Department of Neurology (O.E.L.-S.), Clínica de la Costa, Barranquilla, Colombia; Department of Neurology (Martin Cabal), Faculty Hospital Ostrava, Czech Republic; Department of Neurology (D.T.), Blansko Hospital, Czech Republic; Oblastní Nemocnice Trutnov a.s. (Petr Fibrich), Czech Republic; Department of Neurology (R.H.), Comprehensive Stroke Center, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic; Neurology (H.H.), Hospital Příbram, Czech Republic; Uherskohradišťská Hospital (E.H.), Czech Republic; Department of Neurology (D.H.), Thomayer University Hospital Prague, Czech Republic; Neurocenter (L.J.), Regional Hospital Liberec, Czech Republic; Neurology (Jana Kadlcikova), Hospital Vyskov, Czech Republic; Regional Hospital Karlovy Vary (Igor Karpowicz), Czech Republic; Ostrava (L.K.), Czech Republic; Na Homolce Hospital (Martin Kovar), Czech Republic; Department of Neurology (D.L.), Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Czech Republic; Department of Neurology (J.N.E.S.O.), Krajská zdravotní, a.s.-Hospital Chomutov, Chomutov, Czech Republic; Karvina Mining Hospital (H.P.), Czech Republic; Neurology (Martin Reiser), České Budejovice Hospital, Czech Republic; Department of Neurology and Centre of Clinical Neuroscience (Petra Rekova), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Department of Neurology (V.R.), University Hospital Plzen, Czech Republic; Department of Neurology (O.S.), Hospital Jihlava, Czech Republic; Department of Neurology (M.Š.), Masaryk University Faculty of Medicine, University Hospital Brno, Czech Republic; Oblastni Nemocnice Kladno (L.S.), Czech Republic; Central Military Hospital in Prague (Martin Sramek), Czech Republic; Nemocnice Třinec (Lenka Zakova), Czech Republic; Copenhagen University Hospital (H.C., N.D.), Denmark; Stroke Center (H.K.I., T.C.T.), Rigshospitalet, University of Copenhagen, Denmark; Neurovascular Center (T.W.), Zealand University Hospital, University of Copenhagen, Roskilde, Denmark; El hussein Alzahar University Hospital (Khalid Sobh), Egypt; Neurocenter (P.Y.), Turku University Hospital, Turku University, Finland; Department of Radiology (K.A.), Turku University Hospital, Finland; Department of Neurology (Daniel Strbian), Helsinki University Hospital and University of Helsinki, Finland; Bayonne Hospital Neurology (P.B.), Stroke Unit, France; Libourne Hospital Neurology (Philippe Casenave), Stroke Unit, France; Centre Hospitalier d'Arcachon-Neurologie (Maria Dan), France; Agen Hospital Neurology (J.-M.F.), Stroke Unit, France; Neuroradiologie Interventionelle (J.-C.G.), Brest University Hospital, France; Neurochirurgie (E.M.), Brest University Hospital, France; Department of Neurology (C.S.), Rothschild Foundation Hospital, Paris, France; Lariboisiere Hospital (Peggy Reiner), Paris, France; Bordeaux University Hospital Neurology (F.R.), Stroke Unit, France; Department of Neurology (F.O.B.), University Hospital, Goethe University, Frankfurt, Germany; Department of Neurology (Stefan Boskamp, Michael Rosenkranz), Albertinen Krankenhaus, Hamburg, Germany; Department of Neurology and Stroke (Joshua Mbroh, S.P.), Eberhard-Karls University, Tuebingen, Germany; Hertie Institute for Clinical Brain Research (Joshua Mbroh, S.P.), Eberhard-Karls University, Tuebingen, Germany; Department of Neurology (Simon Nagel), Klinikum Ludwigshafen, Ludwigshafen/Rhein, Germany; Department of Neurology (Simon Nagel, P.A.R.), Heidelberg University Hospital, Germany; Department of Neurology and Experimental Neurology (C.H.N.), Center for Stroke Research Berlin, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Germany; Universitätsklinikum Hamburg-Eppendorf (Götz Thomalla), Klinik und Poliklinik für Neurologie, Hamburg, Germany; Second Department of Neurology (Theodoros Karapanayiotides, Ioanna Koutroulou), AHEPA University Hospital, Aristotle University of Thessaloniki, School of Medicine, Faculty of Health Sciences, Greece; Stroke Unit (O.K.), Metropolitan Hospital, Piraeus, Greece; Hospital General San Juan de Dios (J.D.B.G.), Guatemala; Mazumdar Shaw Medical Center (V.H.), Bangalore, Karnataka, India; Department of Neurology (Bindu Menon), Apollo Specialty Hospitals Nellore, Andhra Pradesh, India; Department of Neurology (Shashank Nagendra), Grant Medical College and Sir JJ Hospital, Mumbai, India; Mazumdar Shaw Medical Center (C.P.), Bangalore, Karnataka, India; Sree Chitra Tirunal Institute for Medical Sciences and Technology (P.N.S.), Trivandrum, Kerala, India; Department of Neurology (N.A.K.P.), Faculty of Medicine Udayana University, Sanglah General Hospital Denpasar, Bali, Indonesia; Dr. Soetomo General Hospital Surabaya (A.F.S.), Universitas Airlangga, Indonesia; Stroke Research Group (A.G.), Head of Stroke Care Unit, Department of Neurology, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Iran; Neurosciences Research Center (Mehdi Farhoudi, E.S.H.), Imam Reza Hospital, Tabriz University of Medical Sciences, Iran; Neurology Department (T.A.R., S.I.S.), Hillel Yaffe Medical Center, Hadera, Israel; Neurointerventional Unit (S.A.K., Levite Ronen), Shamir Medical Center, Israel; Stroke Unit (Maurizio Acampa), University of Siena, Italy; Stroke Center IRCCS Sacro Cuore Don Calabria (A.A.), Verona, Italy; Dipartimento di Neuroradiologia Diagnostica e Interventistica Policinico Universitario IRCCS San Martino (Lucio Castellan, C.R.B.), Genova, Italy; Neurology and Stroke Unit (M.L., Michele Romoli), Ospedale Bufalini, Cesena, Italy; Neuroscience Section (R.O., Simona Sacco), Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy; Interventional Neurovascular Unit (Leonardo Renieri), Careggi University Hospital, Florence, Italy; Neurological Department (Andrea Salmaggi, Davide Sangalli), "Alessandro Manzoni" Hospital, ASST Lecco, Via dell'Eremo, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (A.Z.), Neurologia e Rete Stroke Metropolitana, Italy; Department of Neurosurgery (R.D., N.K.), Iwate Prefectural Central Hospital, Japan; Department of Neurology (H.F.), Japanese Red Cross Matsue Hospital, Japan; Department of Neurosurgery (T.F.), National Hospital Organization Osaka National Hospital, Japan; Department of Endovascular Surgery (K.F.), Tokyo Medical and Dental University, Japan; Department of Neurosurgery (H.I., N.S.), Kobe City Medical Center General Hospital, Japan; NTT Medical Center Tokyo (Takuya Kanamaru), Japan; Department of Neurology (Ryuhei Kono), Kin-ikyo Chuo Hospital, Japan; Shiroyama Hospital (K.M.), Japan; Department of Neurology (Manabu Sakaguchi), Osaka General Medical Center, Japan; Department of Neurology (Kenichiro Sakai), The Jikei University School of Medicine, Japan; Department of Neurology (Kazutaka Sonoda), Saiseikai Fukuoka General Hospital, SFGH, Japan; Stroke Center (Kenichi Todo), Osaka University Hospital, Japan; Department of Neurology (Fumio Miyashita), Kagoshima City Hospital, Japan; Department of Neurology (N.T.), Japanese Red Cross Kyoto Daini Hospital, Japan; Department of Stroke and Cerebrovascular Diseases (Y.M.), University of Tsukuba Hospital, Japan; Comprehensive Strokology (S.M.), Fujita Health University School of Medicine, Toyoake, Japan; Department of Neurology (N.O.), Kobe City Medical Center General Hospital, Japan; Department of Neurology (Seigo Shindo), Japanese Red Cross Kummoto Hospital, Japan; Osaka Red Cross Hospital (Y.T.), Japan; Department of Neurology (Takeshi Yoshimoto), National Cerebral and Cardiovascular Center, Japan; Department of Cerebrovascular Medicine (Kazunori Toyoda), National Cerebral and Cardiovascular Center, Japan; Cerebrovascular Medicine (T.U.), Stroke Center, Saga Medical Centre Koseikan, Japan; Stroke Medicine (Yoshiki Yagita), Kawasaki Medical School, Japan; Department of Neurology and Stroke Treatment (Takehiro Yamada), Japanese Red Cross Kyoto Daiichi Hospital, Japan; Advanced Brain Research (N.Y.), Tokushima University, Japan; Yokohama Brain and Spine Center (R.Y.), Japan; Department of Stroke Neurology (Yukako Yazawa), Kohnan Hospital, Sendai, Japan; Toyonaka Municipal Hospital (Y.S.), Japan; Kenyatta University Teaching (P.K.W.), Referral and Research Hospital, Kenya; Department of Neurology (J.-H.B.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Neurology (S.B.L.), Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea; Department of Neurology (K.-D.S.), National Health Insurance Service Ilsan Hospital, Goyang, Korea; Department of Neurology (S.-I.S.), Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea; Department of Urgent Neurology (A.A.A.), University Clinic of Neurology, University Ss. Cyril and Methodius-Faculty of Medicine, Skopje, North Macedonia; Hospital Sultan Abdul Halim (Y.C.C.), Malaysia; Department of Medicine (W.A.W.Z.), National University of Malaysia; Department of Surgery (A.S.J.), National University of Malaysia; Neurovascular Unit and Neurology Department (F.G.-R., A.I.-V.), University Hospital Jose Eleuterio Gonzalez, Universidad Autonoma de Nuevo Leon, Mexico; Department of Neurology (M.M.-M.), Hospital de especialidades del Centro Médico Nacional Siglo XXI IMSS, Mexico; "Nicolae Testemitanu" State University of Medicine and Pharmacy (S.G., Pavel Leahu); Emergency Medicine Institute (L.P., S.G.), Chisinau, Republic of Moldova; Amsterdam University Medical Centers Amsterdam (J.M.C., L.A.R.), the Netherlands; Departments of Neurology (D.W.J.D.) and Neurology and Radiology (D.H.K.D.-N.), Erasmus University Medical Center Rotterdam, the Netherlands; Department of Medicine (Annemarei Ranta), University of Otago-Wellington, and Department of Neurology, Wellington Hospital, New Zealand; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Department of Medical Records (T.T.A.), Federal Medical Centre, Owo, Ondo State, Nigeria; Neurology Unit (A.H.B., K.W.W.), University of Ilorin, Nigeria; Neurology Unit (E.O.N.), Department of Medicine, Federal Medical Centre Owerri, Neurology Unit, Federal Medical Centre, Owerri, Nigeria; Neurology Unit, Department of Medicine, (T.A.S.) Federal Medical Center, Owo, Ondo State, Nigeria; Department of Neurology (O.M.R.), Akershus University Hospital, Norway, and Institute of Clinical Medicine, University of Oslo, Norway; Department of Neurology (E.C.S.), Oslo, Oslo, Norway and The Norwegian Air Ambulance Foundation, Norway; Central Stroke Unit (A.M.A.H.), Neuroscience Directorate, Khoula Hospital, Ministry of Health, Oman; Lahore General Hospital (S.A., U.R.), Pakistan; Departamento de Neurología (L.R.-K., M.Á.V.), Hospital Nacional Edgardo Rebagliati Martins,Essalud, Lima, Perú; St. Luke's Medical Center (P.M.Y.), Global City, Philippines; St. Luke's Medical Center (J.S.H.D., M.C.P.-F., C.O.C.), Quezon City, Philippines; Department of Neurology (W.B.), Specialist Hospital Konskie, Collegium Medicum, Jan Kochanowski University, Kielce, Poland; Clinic of Neurology (Aleksander Debiec, J.S.), Military Institute of Medicine, Warsaw, Poland; Department of Neurology (Malgorzata Dorobek), Central Clinical Hospital of the Ministry of Interior and Administration (M.D.), Warsaw, Poland; Department of Neurology (B.M.L.-R.), St. Jadwiga Provincial Specialist Hospital in Opole, Institute of Medical Sciences, University of Opole, Poland; Department of Neurology (A.L.-B.), Leszek Giec Upper Silesian Medical Centre of the Silesian Medical University in Katowice, School of Health Sciences, Medical University of Silesia in Katowice, Poland; 1st Department of Neurology (H.S.-J.), Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Neurology in Sandomierz (Piotr Sobolewski), Collegium Medicum, Jan Kochanowski University in Kielce, Sandomierz, Poland; Department of Neurology (M.W.), Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland; Department of Neurology (J.Z.-T.), Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland; Department of Neurology (J.Z.-T.), Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland; Neuroradiology Department-Centro Hospitalar de Vila Nova de Gaia/Espinho (A.P.A.), Portugal; Neurology Department (Mariana Rocha), Centro Hospitalar Vila Nova de Gaia/Espinho; Department of Neurology (Pedro Castro), Centro Hospitalar Universitário de São João, Portugal; Stroke Unit-Hospital Pedro Hispano (V.T.C., P.V.F.), Matosinhos, Portugal; Stroke Unit (Patricia Ferreira, A.P.N.), Centro Hospitalar Universitário de Lisboa Central, Portugal; Stroke Unit (Luisa Fonseca), Medicine Department, Centro Hospitalar Universitário de São João, Portugal; Department of Neurology (J.P.M.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; Hospital de Santa Maria-Centro Hospitalar Lisboa Norte (T.P.M.), Portugal; Department of Neurology (Miguel Rodrigues), Hospital Garcia de Orta, Almada, Portugal; Centro Hospitalar Universitário de São João (M.L.S.), Portugal; Bucarest University Emergency Hospital (Adela Dimitriade), Romania; Department of Neurology (C.F.-P.), County Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania; Department of Neurology King Fahad Hospital of the University Imam Abdulrahman bin Faisal University Dammam (M.A.H.), Saudi Arabia; Raffles Hospital (N.V.), Singapore; Department of Neurology (G.K., Miroslav Mako), Faculty Hospital Trnava, Slovakia; Jessenius Medical Faculty (G.K., M.M.), Martin, Commenius University, Bratislava, Slovakia; Department of Neurology (G.K.), Slovak Medical University, Bratislava; Complejo Hospitalario Universitario de Albacete (O.A.-M., F.H.-F.), Albacete, Spain; Interventional Neuroradiology (J.B.), Hospital Clínic de Barcelona, Spain; Comprehensive Stroke Center (A.R.-V.), Hospital Clínic de Barcelona, Spain; Department of Neurology (Unidad de Ictus) (A.C.-C.), Hospital Universitario Ramón y Cajal, Madrid, Spain; Stroke Unit (Francisco Moniche), Neurology Department, Hospital Universitario Virgen del Rocío, Spain; Department of Neurology (Joan Montaner, S.P.-S.), Hospital Universitario Virgen Macarena & Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla-IbiS, Spain; Department of Neuroradiology (M.J.G.S.), Hospital Universitario Rey Juan Carlos, Spain; Department of Neurology (M.G.R.), Hospital Universitario Rey Juan Carlos, Spain; Institute of Neuroscience and Physiology (K.J., A.N.), Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg; Department of Neurology (K.J., A.N.), Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden; Department of Neurology (M.V.M., T.T.P.M.), Karolinska University Hospital & Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Interventional Neuroradiology (G.B.), University Hospitals of Geneva, Switzerland; Department of Neurology (Morin Beyeler, U.F.), Inselspital, Bern University Hospital; Neurocenter (Manuel Bolognese), Cantonal Hospital of Lucerne, Switzerland; Department of Neurology (E.C.), University Hospitals of Geneva, Switzerland; Diagnostic and Interventional Neuroradiology (T.D.), Bern University Hospital, University of Bern, Switzerland; Radiology and Nuclear Medicine (G.M.K.), Cantonal Hospital of Lucerne, Switzerland; University Hospital (E.K.), University of Zurich, Switzerland; Department of Neurology (C.Y.H.), Tainan Sin Lau Hospital, Taiwan; Department of Radiology (Surawan Boonyakarnkul), Ramathibodi Hospital, Mahidol University, Thailand; Department of Radiology (Anchalee Churojana), Siriraj Hospital, Mahidol University, Thailand; Eskisehir Osmangazi University (O.A., M.D.O.), Turkey; Istanbul Aydın University (A.B., Songul Senadim), Florya Medicalpark Stroke Center, Turkey; Cleveland Clinic Abu Dhabi (S.I.H., S.J.), UAE; Department of Stroke Medicine (Soma Banerjee, Joseph Kwan), Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom; Stroke (K.K.), Department of Medicine (K.K.), Nottingham University Hospitals NHS Trust, United Kingdom; Neuroradiology (Robert Lenthall), Nottingham University Hospitals NHS Trust, United Kingdom; Barking Havering and Redbridge University Hospitals (Ashok Matthews), Romford, United Kingdom; Royal London Hospital (K.W.), Barts Health NHS Trust, United Kingdom; St George's University Hospital (Liqun Zhang), London, United Kingdom; Valley Hospital Health System (D.A.), Neurosurgeons of NJ, New Jersey; Amita Health and University of Illinois-Chicago (K.S.A.); Inova Fairfax Hospital (Z.B.), Virginia; Neuroscience and Stroke Program (K.B., O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Loyola University Chicago Stritch School of Medicine (J.B.A.N.A., S.R.), Illinois; Inova Fairfax Hospital (S.A.C.), University of Virginia School of Medicine, Virginia; Rush University Medical Center (Michael Chen, Y.R.), Chicago, IL; Department of Neurology (Alex Chebl), Henry Ford Health System, Detroit, MI; Clinical Data Specialist (Jackie Cibulka), EBC Data Abstraction, University of Tennessee Health Science Center; Solution Architect II (Leon Cistrunk), Clinical Decision Support, University of Tennessee Health Science Center; Department of Radiology (Marco Colasurdo), University of Texas Medical Branch, Galveston, TX; Neurology (Alexandra Czap, S.A.S.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (A.H.), Yale University School of Medicine, New Haven; Brigham and Women's Hospital (S.D.A., A.A.D.), Boston; Baptist Health Medical Center-Little Rock (S.D., K.B.G.), Little Rock, AR; Neurointerventional Program (A.A.D.), Departments of Medical Imaging and Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON; Neuroendovascular Program (A.A.D.), Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (M.R.E., N.S.R.), Massachusetts General Hospital, Boston; Department of Interventional and Vascular Neurology (Chizoba Ezepue), Neuroscience Center, SSM Health DePaul Hospital, St. Louis, Missouri; University of Iowa (Mudassir Farooqui, S.O.G.); Santa Barbara Cottage Hospital (Lauren Fink, R.A.T.), California; Department of Neurology (U.G.), Saint Louis University School of Medicine, Missouri; Department of Neurology (A.K.G., S.L.), Wake Forest Baptist Medical Center, NC; Wayne State University (M.H.G.N.P., A.M.K.), Detroit, MI; Department of Neurosciences and Comprehensive Stroke Center (M.H., Muhib Khan), Spectrum Health and Michigan State University College of Human Medicine; Department of Neurology (D.J.), Grady Memorial Hospital, Emory University School of Medicine; Department of Neurosurgery (P.T.K.), University of Texas Medical Branch; Department of Neurology (Rakesh Khatri), Texas Tech University Health Science Center, El Paso; HSHS St. John's Hospital (N.N.K.), Southern Illinois University School of Medicine, Springfield; Virginia Hospital Center (B.S.K.); Baptist Health Medical Group (M.K.K.), Baptist Health Lexington, KY; Division of Neurointerventional Radiology (A.L.K., A.S.P.), Department of Radiology, University of Massachusetts Medical Center, Worcester, MA; Community Memorial Hospital (S.L.-H.C.A.,S.C.R.N., N.E.T.), Ventura, CA; Vascular and Neurointerventional Services (G.L.), Saint Louis University, Missouri; Miami Cardiac & Vascular Institute (I.L.), Miami Neuroscience Institute, FL; Dartmouth Hitchcock Medical Center (T.G.L., D.M.R.-S.), Lebanon, NH; Department of Neurology & Neurosurgery (S.S.M.), ECU Health Medical Center, Greenville, NC; Department of Neurology (L.M.), University of Kansas Medical Center; West Virginia University (John Mancin, Ansaar Rai); Department of Neurology (H.M., A.B.R.), SUNY Upstate, Syracuse, NY; Department of Neurology (G.A.M.), Medical University of South Carolina; Department of Neurosurgery (Andre Monteiro, A.H.S.), University at Buffalo; Department of Neurology (F.N.), Pediatrics, Emory University, Georgia; Department of Neurology (K.N.), University of Arkansas for Medical Sciences, Arkansas; Ascension St Johns Medical Center (R.H.R.), Tulsa, OK; Riverside Regional Medical Center (Pankajavalli Ramakrishnan), Newport News, VA; Department of Neurology (Aaron Rothstein), Hospital of the University of Pennsylvania, Philadelphia; University of Colorado School of Medicine (S.S.O.), Aurora, CO; Miami Neuroscience Institute (A.K.S.), Miami; UNC School of Medicine (M.J.W.), North Carolina; University of Utah (K.-H.W.); Hue Central (H.V.L., Q.V.N.), Vietnam; Da Nang Hospital (T.N.P., T.T.N.), Da Nang, Vietnam; Bach Mai Hospital (H.T.P., M.D.T.), Hanoi, Vietnam; Department of Neurology (U.F.), Basel University Hospital, University of Basel, Switzerland; Neurology Service (P.M., Davide Strambo), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (S.O.M.), Federal University of Rio Grande do Sul, Porto Alegre; Hospital de Clínicas de Porto Alegre (S.O.M.), Brazil; and Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, Pittsburgh. Ondrej Skoda is currently at the Department of Neurology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. [email protected]
² From the Department of Neurology (T.N.N., P.K., Anvitha Sathya, H.C.L., Andreas Charidimou, Judith Clark, S.K.F., J.R.R.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine; Department of Radiology (T.N.N., M.M.Q., P.K., Mohamad Abdalkader, Anvitha Sathya, H.C.L., N.L.K.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine; Department of Stroke Neurology (H.Y.), National Hospital Organization, Osaka National Hospital, Japan; Department of Neurology (R.M., Petra Sedova), International Clinical Research Centre, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic; 2nd Department of Neurology (Anna Czlonkowska, M.A.K.), Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Internal Medicine and Cardiology (Petra Sedova), University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Neurology (O.Y.M.), Alexandria University Stroke and Neurointervention Unit, Egypt; Department of Neurology (H.R.V., K.U.), Cleveland Clinic; Centre Hospitalier de l'Université de Bordeaux (E.L.), INSERM, Bordeaux Population Health Research Center, France; Second Department of Neurology (Georgios Tsivgoulis, Lina Palaiodimou), "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece; Ohio Health Riverside Methodist Hospital (A.I.L.); Neurology Department (J.D., Robin Lemmens), Leuven University Hospital, Belgium; University of Tennessee Health Science Center (V.I., N.G.); Cooper Neurological Institute (J.E.S., J.W.), Cooper University Hospital, Camden, NJ; Department of Neurology (Shadi Yaghi), Rhode Island Hospital, Brown University, Providence; Stroke Center (D.A.S.), Centro Hospitalar Universitário Lisboa Central-CHULC, Portugal, CEEM; Institute of Anatomy (D.A.S.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Neurology (Mahmoud Mohammaden, D.C.H.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Neurology (E.S.K.), Akershus University Hospital, University of Oslo, Norway and Department of General Practice, University of Oslo, Norway; Division de Neurologia Vascular (V.P.L.), Departmento de Neurologia, Institute for Neurological Research-FLENI, Buenos Aires, Argentina; Stroke Unit (S.D.S.), Ramos Mejia Hospital, Buenos Aires, Argentina; Department of Medicine and Neurology (B.C.V.C.), Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Royal North Shore Hospital (Alice Ma), Sydney, Australia; Department of Neurophysiology (J.O.T), Liverpool Hospital, New South Wales, Australia; Department of Neurology (M.W.P.), Liverpool Hospital, New South Wales, Australia; Departments of Neurology (Shaloo Singal) and Radiology (L.-A.S.), Monash Medical Centre, Australia; Stroke and Aging Research Group (Shaloo Singhal), School of Clinical Sciences at Monash Health, Monash University, Australia; Department of Neurology (Rodrigo Tomazini Martins), Mater Hospital, Brisbane, Australia; Department of Neurology (Chris Enzinger), Medical University of Graz, Austria; Department of Neurology and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Medical University of Graz, Austria; Department of Neurology (Aminur Rahman), Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh; Hopital Erasme (T.B., N.L.), Brussels, Belgium; Department of Neurology (S.D.R., F.V.), Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel, Belgium; Department of Neurology (P.V.), University Hospitals Antwerp; Department of Translational Neuroscience (P.V.), University of Antwerp, Belgium; Hospital das Clínicas (A.B.C., I.L.S.), São Paulo University, Brazil; Department of Neurology and Interventional Neuroradiology (R.C.T.H.), Hospital de Base de São José do Rio Preto, São Paulo, Brazil; Department of Neurology (L.O.N., I.B.S.), Hospital São Carlos, Fortaleza, Ceará, Brazil Stroke Unit (Rodrigo Targa Martins), Neurology, Nossa Senhora da Conceição Hospital, Porto Alegre, Brazil; Moinhos de Vento Hospital (D.L.M.C.), Brazil; Hospital de Base do Distrito Federal (L.C.R.), Brasilia, Brazil; St. Anna University Hospital (T.S., Rosen Kalpachki, F.A.), Sofia, Bulgaria; Department of Neurology (Luciana Catanese), McMaster University, Hamilton, Canada; Department of Diagnostic Radiology (E.A.C.), Halifax Infirmary, Dalhousie University, Halifax, Canada; Departments of Clinical Neurosciences and Radiology (M.G., M.D.H.), Hotchkiss Brain Institute, Cummings School of Medicine, University of Calgary, Canada; Royal University Hospital (M.E.K., Lissa Peeling), Saskatoon, Saskatchewan, Canada; Department of Neurology (H.K.), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Division of Neurology, Department of Medicine, University of Toronto, Canada; Hopital Enfant Jesus (Pascale Lavoie), Centre Hospitalier de l'Université Laval, Quebec City, Canada; Toronto Western Hospital (A.P.), University of Toronto, Canada; Neuroradiology Department (R.R.), Instituto de Neurocirugía Dr. Asenjo, Santiago, Chile; Department of Neurology (H.-S.C.), General Hospital of Northern Theater Command, Shen Yang, China; Department of Neurology (Y.C., Shuiquan Yang), Foshan Sanshui District People's Hospital, China; Interventional Neuroradiology (X.H., Z.M.), Beijing Tiantian Hospital, China; Department of Neurology (M.R.B.), Sestre Milosrdnice University Hospital Center, Croatia; Department of Neurology (Marina Bralic), Clinical Hospital Center Rijeka, Croatia; Sveti Duh University Hospital - Zagreb (H.B.), Department of Neurology, Croatia; J.J. Strossmayer University of Osijek (H.B.), Faculty of Medicine, Department of Neurology and Neurosurgery, Osijek, Croatia; Department of Neurology (A.B.C.-Q.), Hospital Departamental Universitario del Quindío San Juan de Dios, Colombia; Department of Neurology (O.E.L.-S.), Clínica de la Costa, Barranquilla, Colombia; Department of Neurology (Martin Cabal), Faculty Hospital Ostrava, Czech Republic; Department of Neurology (D.T.), Blansko Hospital, Czech Republic; Oblastní Nemocnice Trutnov a.s. (Petr Fibrich), Czech Republic; Department of Neurology (R.H.), Comprehensive Stroke Center, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic; Neurology (H.H.), Hospital Příbram, Czech Republic; Uherskohradišťská Hospital (E.H.), Czech Republic; Department of Neurology (D.H.), Thomayer University Hospital Prague, Czech Republic; Neurocenter (L.J.), Regional Hospital Liberec, Czech Republic; Neurology (Jana Kadlcikova), Hospital Vyskov, Czech Republic; Regional Hospital Karlovy Vary (Igor Karpowicz), Czech Republic; Ostrava (L.K.), Czech Republic; Na Homolce Hospital (Martin Kovar), Czech Republic; Department of Neurology (D.L.), Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Czech Republic; Department of Neurology (J.N.E.S.O.), Krajská zdravotní, a.s.-Hospital Chomutov, Chomutov, Czech Republic; Karvina Mining Hospital (H.P.), Czech Republic; Neurology (Martin Reiser), České Budejovice Hospital, Czech Republic; Department of Neurology and Centre of Clinical Neuroscience (Petra Rekova), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Department of Neurology (V.R.), University Hospital Plzen, Czech Republic; Department of Neurology (O.S.), Hospital Jihlava, Czech Republic; Department of Neurology (M.Š.), Masaryk University Faculty of Medicine, University Hospital Brno, Czech Republic; Oblastni Nemocnice Kladno (L.S.), Czech Republic; Central Military Hospital in Prague (Martin Sramek), Czech Republic; Nemocnice Třinec (Lenka Zakova), Czech Republic; Copenhagen University Hospital (H.C., N.D.), Denmark; Stroke Center (H.K.I., T.C.T.), Rigshospitalet, University of Copenhagen, Denmark; Neurovascular Center (T.W.), Zealand University Hospital, University of Copenhagen, Roskilde, Denmark; El hussein Alzahar University Hospital (Khalid Sobh), Egypt; Neurocenter (P.Y.), Turku University Hospital, Turku University, Finland; Department of Radiology (K.A.), Turku University Hospital, Finland; Department of Neurology (Daniel Strbian), Helsinki University Hospital and University of Helsinki, Finland; Bayonne Hospital Neurology (P.B.), Stroke Unit, France; Libourne Hospital Neurology (Philippe Casenave), Stroke Unit, France; Centre Hospitalier d'Arcachon-Neurologie (Maria Dan), France; Agen Hospital Neurology (J.-M.F.), Stroke Unit, France; Neuroradiologie Interventionelle (J.-C.G.), Brest University Hospital, France; Neurochirurgie (E.M.), Brest University Hospital, France; Department of Neurology (C.S.), Rothschild Foundation Hospital, Paris, France; Lariboisiere Hospital (Peggy Reiner), Paris, France; Bordeaux University Hospital Neurology (F.R.), Stroke Unit, France; Department of Neurology (F.O.B.), University Hospital, Goethe University, Frankfurt, Germany; Department of Neurology (Stefan Boskamp, Michael Rosenkranz), Albertinen Krankenhaus, Hamburg, Germany; Department of Neurology and Stroke (Joshua Mbroh, S.P.), Eberhard-Karls University, Tuebingen, Germany; Hertie Institute for Clinical Brain Research (Joshua Mbroh, S.P.), Eberhard-Karls University, Tuebingen, Germany; Department of Neurology (Simon Nagel), Klinikum Ludwigshafen, Ludwigshafen/Rhein, Germany; Department of Neurology (Simon Nagel, P.A.R.), Heidelberg University Hospital, Germany; Department of Neurology and Experimental Neurology (C.H.N.), Center for Stroke Research Berlin, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Germany; Universitätsklinikum Hamburg-Eppendorf (Götz Thomalla), Klinik und Poliklinik für Neurologie, Hamburg, Germany; Second Department of Neurology (Theodoros Karapanayiotides, Ioanna Koutroulou), AHEPA University Hospital, Aristotle University of Thessaloniki, School of Medicine, Faculty of Health Sciences, Greece; Stroke Unit (O.K.), Metropolitan Hospital, Piraeus, Greece; Hospital General San Juan de Dios (J.D.B.G.), Guatemala; Mazumdar Shaw Medical Center (V.H.), Bangalore, Karnataka, India; Department of Neurology (Bindu Menon), Apollo Specialty Hospitals Nellore, Andhra Pradesh, India; Department of Neurology (Shashank Nagendra), Grant Medical College and Sir JJ Hospital, Mumbai, India; Mazumdar Shaw Medical Center (C.P.), Bangalore, Karnataka, India; Sree Chitra Tirunal Institute for Medical Sciences and Technology (P.N.S.), Trivandrum, Kerala, India; Department of Neurology (N.A.K.P.), Faculty of Medicine Udayana University, Sanglah General Hospital Denpasar, Bali, Indonesia; Dr. Soetomo General Hospital Surabaya (A.F.S.), Universitas Airlangga, Indonesia; Stroke Research Group (A.G.), Head of Stroke Care Unit, Department of Neurology, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Iran; Neurosciences Research Center (Mehdi Farhoudi, E.S.H.), Imam Reza Hospital, Tabriz University of Medical Sciences, Iran; Neurology Department (T.A.R., S.I.S.), Hillel Yaffe Medical Center, Hadera, Israel; Neurointerventional Unit (S.A.K., Levite Ronen), Shamir Medical Center, Israel; Stroke Unit (Maurizio Acampa), University of Siena, Italy; Stroke Center IRCCS Sacro Cuore Don Calabria (A.A.), Verona, Italy; Dipartimento di Neuroradiologia Diagnostica e Interventistica Policinico Universitario IRCCS San Martino (Lucio Castellan, C.R.B.), Genova, Italy; Neurology and Stroke Unit (M.L., Michele Romoli), Ospedale Bufalini, Cesena, Italy; Neuroscience Section (R.O., Simona Sacco), Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy; Interventional Neurovascular Unit (Leonardo Renieri), Careggi University Hospital, Florence, Italy; Neurological Department (Andrea Salmaggi, Davide Sangalli), "Alessandro Manzoni" Hospital, ASST Lecco, Via dell'Eremo, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (A.Z.), Neurologia e Rete Stroke Metropolitana, Italy; Department of Neurosurgery (R.D., N.K.), Iwate Prefectural Central Hospital, Japan; Department of Neurology (H.F.), Japanese Red Cross Matsue Hospital, Japan; Department of Neurosurgery (T.F.), National Hospital Organization Osaka National Hospital, Japan; Department of Endovascular Surgery (K.F.), Tokyo Medical and Dental University, Japan; Department of Neurosurgery (H.I., N.S.), Kobe City Medical Center General Hospital, Japan; NTT Medical Center Tokyo (Takuya Kanamaru), Japan; Department of Neurology (Ryuhei Kono), Kin-ikyo Chuo Hospital, Japan; Shiroyama Hospital (K.M.), Japan; Department of Neurology (Manabu Sakaguchi), Osaka General Medical Center, Japan; Department of Neurology (Kenichiro Sakai), The Jikei University School of Medicine, Japan; Department of Neurology (Kazutaka Sonoda), Saiseikai Fukuoka General Hospital, SFGH, Japan; Stroke Center (Kenichi Todo), Osaka University Hospital, Japan; Department of Neurology (Fumio Miyashita), Kagoshima City Hospital, Japan; Department of Neurology (N.T.), Japanese Red Cross Kyoto Daini Hospital, Japan; Department of Stroke and Cerebrovascular Diseases (Y.M.), University of Tsukuba Hospital, Japan; Comprehensive Strokology (S.M.), Fujita Health University School of Medicine, Toyoake, Japan; Department of Neurology (N.O.), Kobe City Medical Center General Hospital, Japan; Department of Neurology (Seigo Shindo), Japanese Red Cross Kummoto Hospital, Japan; Osaka Red Cross Hospital (Y.T.), Japan; Department of Neurology (Takeshi Yoshimoto), National Cerebral and Cardiovascular Center, Japan; Department of Cerebrovascular Medicine (Kazunori Toyoda), National Cerebral and Cardiovascular Center, Japan; Cerebrovascular Medicine (T.U.), Stroke Center, Saga Medical Centre Koseikan, Japan; Stroke Medicine (Yoshiki Yagita), Kawasaki Medical School, Japan; Department of Neurology and Stroke Treatment (Takehiro Yamada), Japanese Red Cross Kyoto Daiichi Hospital, Japan; Advanced Brain Research (N.Y.), Tokushima University, Japan; Yokohama Brain and Spine Center (R.Y.), Japan; Department of Stroke Neurology (Yukako Yazawa), Kohnan Hospital, Sendai, Japan; Toyonaka Municipal Hospital (Y.S.), Japan; Kenyatta University Teaching (P.K.W.), Referral and Research Hospital, Kenya; Department of Neurology (J.-H.B.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Neurology (S.B.L.), Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea; Department of Neurology (K.-D.S.), National Health Insurance Service Ilsan Hospital, Goyang, Korea; Department of Neurology (S.-I.S.), Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea; Department of Urgent Neurology (A.A.A.), University Clinic of Neurology, University Ss. Cyril and Methodius-Faculty of Medicine, Skopje, North Macedonia; Hospital Sultan Abdul Halim (Y.C.C.), Malaysia; Department of Medicine (W.A.W.Z.), National University of Malaysia; Department of Surgery (A.S.J.), National University of Malaysia; Neurovascular Unit and Neurology Department (F.G.-R., A.I.-V.), University Hospital Jose Eleuterio Gonzalez, Universidad Autonoma de Nuevo Leon, Mexico; Department of Neurology (M.M.-M.), Hospital de especialidades del Centro Médico Nacional Siglo XXI IMSS, Mexico; "Nicolae Testemitanu" State University of Medicine and Pharmacy (S.G., Pavel Leahu); Emergency Medicine Institute (L.P., S.G.), Chisinau, Republic of Moldova; Amsterdam University Medical Centers Amsterdam (J.M.C., L.A.R.), the Netherlands; Departments of Neurology (D.W.J.D.) and Neurology and Radiology (D.H.K.D.-N.), Erasmus University Medical Center Rotterdam, the Netherlands; Department of Medicine (Annemarei Ranta), University of Otago-Wellington, and Department of Neurology, Wellington Hospital, New Zealand; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Department of Medical Records (T.T.A.), Federal Medical Centre, Owo, Ondo State, Nigeria; Neurology Unit (A.H.B., K.W.W.), University of Ilorin, Nigeria; Neurology Unit (E.O.N.), Department of Medicine, Federal Medical Centre Owerri, Neurology Unit, Federal Medical Centre, Owerri, Nigeria; Neurology Unit, Department of Medicine, (T.A.S.) Federal Medical Center, Owo, Ondo State, Nigeria; Department of Neurology (O.M.R.), Akershus University Hospital, Norway, and Institute of Clinical Medicine, University of Oslo, Norway; Department of Neurology (E.C.S.), Oslo, Oslo, Norway and The Norwegian Air Ambulance Foundation, Norway; Central Stroke Unit (A.M.A.H.), Neuroscience Directorate, Khoula Hospital, Ministry of Health, Oman; Lahore General Hospital (S.A., U.R.), Pakistan; Departamento de Neurología (L.R.-K., M.Á.V.), Hospital Nacional Edgardo Rebagliati Martins,Essalud, Lima, Perú; St. Luke's Medical Center (P.M.Y.), Global City, Philippines; St. Luke's Medical Center (J.S.H.D., M.C.P.-F., C.O.C.), Quezon City, Philippines; Department of Neurology (W.B.), Specialist Hospital Konskie, Collegium Medicum, Jan Kochanowski University, Kielce, Poland; Clinic of Neurology (Aleksander Debiec, J.S.), Military Institute of Medicine, Warsaw, Poland; Department of Neurology (Malgorzata Dorobek), Central Clinical Hospital of the Ministry of Interior and Administration (M.D.), Warsaw, Poland; Department of Neurology (B.M.L.-R.), St. Jadwiga Provincial Specialist Hospital in Opole, Institute of Medical Sciences, University of Opole, Poland; Department of Neurology (A.L.-B.), Leszek Giec Upper Silesian Medical Centre of the Silesian Medical University in Katowice, School of Health Sciences, Medical University of Silesia in Katowice, Poland; 1st Department of Neurology (H.S.-J.), Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Neurology in Sandomierz (Piotr Sobolewski), Collegium Medicum, Jan Kochanowski University in Kielce, Sandomierz, Poland; Department of Neurology (M.W.), Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland; Department of Neurology (J.Z.-T.), Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland; Department of Neurology (J.Z.-T.), Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland; Neuroradiology Department-Centro Hospitalar de Vila Nova de Gaia/Espinho (A.P.A.), Portugal; Neurology Department (Mariana Rocha), Centro Hospitalar Vila Nova de Gaia/Espinho; Department of Neurology (Pedro Castro), Centro Hospitalar Universitário de São João, Portugal; Stroke Unit-Hospital Pedro Hispano (V.T.C., P.V.F.), Matosinhos, Portugal; Stroke Unit (Patricia Ferreira, A.P.N.), Centro Hospitalar Universitário de Lisboa Central, Portugal; Stroke Unit (Luisa Fonseca), Medicine Department, Centro Hospitalar Universitário de São João, Portugal; Department of Neurology (J.P.M.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; Hospital de Santa Maria-Centro Hospitalar Lisboa Norte (T.P.M.), Portugal; Department of Neurology (Miguel Rodrigues), Hospital Garcia de Orta, Almada, Portugal; Centro Hospitalar Universitário de São João (M.L.S.), Portugal; Bucarest University Emergency Hospital (Adela Dimitriade), Romania; Department of Neurology (C.F.-P.), County Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania; Department of Neurology King Fahad Hospital of the University Imam Abdulrahman bin Faisal University Dammam (M.A.H.), Saudi Arabia; Raffles Hospital (N.V.), Singapore; Department of Neurology (G.K., Miroslav Mako), Faculty Hospital Trnava, Slovakia; Jessenius Medical Faculty (G.K., M.M.), Martin, Commenius University, Bratislava, Slovakia; Department of Neurology (G.K.), Slovak Medical University, Bratislava; Complejo Hospitalario Universitario de Albacete (O.A.-M., F.H.-F.), Albacete, Spain; Interventional Neuroradiology (J.B.), Hospital Clínic de Barcelona, Spain; Comprehensive Stroke Center (A.R.-V.), Hospital Clínic de Barcelona, Spain; Department of Neurology (Unidad de Ictus) (A.C.-C.), Hospital Universitario Ramón y Cajal, Madrid, Spain; Stroke Unit (Francisco Moniche), Neurology Department, Hospital Universitario Virgen del Rocío, Spain; Department of Neurology (Joan Montaner, S.P.-S.), Hospital Universitario Virgen Macarena & Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla-IbiS, Spain; Department of Neuroradiology (M.J.G.S.), Hospital Universitario Rey Juan Carlos, Spain; Department of Neurology (M.G.R.), Hospital Universitario Rey Juan Carlos, Spain; Institute of Neuroscience and Physiology (K.J., A.N.), Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg; Department of Neurology (K.J., A.N.), Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden; Department of Neurology (M.V.M., T.T.P.M.), Karolinska University Hospital & Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Interventional Neuroradiology (G.B.), University Hospitals of Geneva, Switzerland; Department of Neurology (Morin Beyeler, U.F.), Inselspital, Bern University Hospital; Neurocenter (Manuel Bolognese), Cantonal Hospital of Lucerne, Switzerland; Department of Neurology (E.C.), University Hospitals of Geneva, Switzerland; Diagnostic and Interventional Neuroradiology (T.D.), Bern University Hospital, University of Bern, Switzerland; Radiology and Nuclear Medicine (G.M.K.), Cantonal Hospital of Lucerne, Switzerland; University Hospital (E.K.), University of Zurich, Switzerland; Department of Neurology (C.Y.H.), Tainan Sin Lau Hospital, Taiwan; Department of Radiology (Surawan Boonyakarnkul), Ramathibodi Hospital, Mahidol University, Thailand; Department of Radiology (Anchalee Churojana), Siriraj Hospital, Mahidol University, Thailand; Eskisehir Osmangazi University (O.A., M.D.O.), Turkey; Istanbul Aydın University (A.B., Songul Senadim), Florya Medicalpark Stroke Center, Turkey; Cleveland Clinic Abu Dhabi (S.I.H., S.J.), UAE; Department of Stroke Medicine (Soma Banerjee, Joseph Kwan), Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom; Stroke (K.K.), Department of Medicine (K.K.), Nottingham University Hospitals NHS Trust, United Kingdom; Neuroradiology (Robert Lenthall), Nottingham University Hospitals NHS Trust, United Kingdom; Barking Havering and Redbridge University Hospitals (Ashok Matthews), Romford, United Kingdom; Royal London Hospital (K.W.), Barts Health NHS Trust, United Kingdom; St George's University Hospital (Liqun Zhang), London, United Kingdom; Valley Hospital Health System (D.A.), Neurosurgeons of NJ, New Jersey; Amita Health and University of Illinois-Chicago (K.S.A.); Inova Fairfax Hospital (Z.B.), Virginia; Neuroscience and Stroke Program (K.B., O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Loyola University Chicago Stritch School of Medicine (J.B.A.N.A., S.R.), Illinois; Inova Fairfax Hospital (S.A.C.), University of Virginia School of Medicine, Virginia; Rush University Medical Center (Michael Chen, Y.R.), Chicago, IL; Department of Neurology (Alex Chebl), Henry Ford Health System, Detroit, MI; Clinical Data Specialist (Jackie Cibulka), EBC Data Abstraction, University of Tennessee Health Science Center; Solution Architect II (Leon Cistrunk), Clinical Decision Support, University of Tennessee Health Science Center; Department of Radiology (Marco Colasurdo), University of Texas Medical Branch, Galveston, TX; Neurology (Alexandra Czap, S.A.S.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (A.H.), Yale University School of Medicine, New Haven; Brigham and Women's Hospital (S.D.A., A.A.D.), Boston; Baptist Health Medical Center-Little Rock (S.D., K.B.G.), Little Rock, AR; Neurointerventional Program (A.A.D.), Departments of Medical Imaging and Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON; Neuroendovascular Program (A.A.D.), Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Neurology (M.R.E., N.S.R.), Massachusetts General Hospital, Boston; Department of Interventional and Vascular Neurology (Chizoba Ezepue), Neuroscience Center, SSM Health DePaul Hospital, St. Louis, Missouri; University of Iowa (Mudassir Farooqui, S.O.G.); Santa Barbara Cottage Hospital (Lauren Fink, R.A.T.), California; Department of Neurology (U.G.), Saint Louis University School of Medicine, Missouri; Department of Neurology (A.K.G., S.L.), Wake Forest Baptist Medical Center, NC; Wayne State University (M.H.G.N.P., A.M.K.), Detroit, MI; Department of Neurosciences and Comprehensive Stroke Center (M.H., Muhib Khan), Spectrum Health and Michigan State University College of Human Medicine; Department of Neurology (D.J.), Grady Memorial Hospital, Emory University School of Medicine; Department of Neurosurgery (P.T.K.), University of Texas Medical Branch; Department of Neurology (Rakesh Khatri), Texas Tech University Health Science Center, El Paso; HSHS St. John's Hospital (N.N.K.), Southern Illinois University School of Medicine, Springfield; Virginia Hospital Center (B.S.K.); Baptist Health Medical Group (M.K.K.), Baptist Health Lexington, KY; Division of Neurointerventional Radiology (A.L.K., A.S.P.), Department of Radiology, University of Massachusetts Medical Center, Worcester, MA; Community Memorial Hospital (S.L.-H.C.A.,S.C.R.N., N.E.T.), Ventura, CA; Vascular and Neurointerventional Services (G.L.), Saint Louis University, Missouri; Miami Cardiac & Vascular Institute (I.L.), Miami Neuroscience Institute, FL; Dartmouth Hitchcock Medical Center (T.G.L., D.M.R.-S.), Lebanon, NH; Department of Neurology & Neurosurgery (S.S.M.), ECU Health Medical Center, Greenville, NC; Department of Neurology (L.M.), University of Kansas Medical Center; West Virginia University (John Mancin, Ansaar Rai); Department of Neurology (H.M., A.B.R.), SUNY Upstate, Syracuse, NY; Department of Neurology (G.A.M.), Medical University of South Carolina; Department of Neurosurgery (Andre Monteiro, A.H.S.), University at Buffalo; Department of Neurology (F.N.), Pediatrics, Emory University, Georgia; Department of Neurology (K.N.), University of Arkansas for Medical Sciences, Arkansas; Ascension St Johns Medical Center (R.H.R.), Tulsa, OK; Riverside Regional Medical Center (Pankajavalli Ramakrishnan), Newport News, VA; Department of Neurology (Aaron Rothstein), Hospital of the University of Pennsylvania, Philadelphia; University of Colorado School of Medicine (S.S.O.), Aurora, CO; Miami Neuroscience Institute (A.K.S.), Miami; UNC School of Medicine (M.J.W.), North Carolina; University of Utah (K.-H.W.); Hue Central (H.V.L., Q.V.N.), Vietnam; Da Nang Hospital (T.N.P., T.T.N.), Da Nang, Vietnam; Bach Mai Hospital (H.T.P., M.D.T.), Hanoi, Vietnam; Department of Neurology (U.F.), Basel University Hospital, University of Basel, Switzerland; Neurology Service (P.M., Davide Strambo), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (S.O.M.), Federal University of Rio Grande do Sul, Porto Alegre; Hospital de Clínicas de Porto Alegre (S.O.M.), Brazil; and Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, Pittsburgh. Ondrej Skoda is currently at the Department of Neurology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic

Neurology, 2023 Jan 24;100(4):e408-e421.

PMID: 36257718 DOI: 10.1212/WNL.0000000000201426

Abstract

BACKGROUND AND OBJECTIVES: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020).

METHODS: We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases.

RESULTS: There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations.

DISCUSSION: There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.

TRIAL REGISTRATION INFORMATION: This study is registered under NCT04934020.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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