Michael Rosenkranz

University Medical Center Hamburg - Eppendorf, Hamburg, Hamburg, Germany

Are you Michael Rosenkranz?

Claim your profile

Publications (52)181.6 Total impact

  • S Zittel, F Ufer, C Gerloff, A Münchau, M Rosenkranz
    Clinical neurology and neurosurgery 06/2014; 121:17-8. · 1.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Analysis of procedural results and 30-day outcome after intracranial angioplasty and stenting (ICAS) with the balloon-expandable Pharos Vitesse stent system in carefully selected high-risk patients in two high-volume neurovascular centers. 92 patients scheduled for elective ICAS using Pharos Vitesse between August, 2008 and August, 2011 were included. All patients showed high-grade intracranial stenosis and recurrent ischemic events despite best medical treatment at that time. The stroke rates and complications were divided into procedural and 30-day short-term events. Successful stent placement was achieved in all but one patient. Ischemic procedural complications occurred in three subjects. 30-Day complications and strokes were seen in four patients: two minor ischemic strokes, one fatal hemorrhage and one non-stroke-related death. Overall, strokes occurred in 6 out of 92 patients (6.5%, 95% CI 3.0% to 13.5%). The total stroke and death rate was 7.6% (95% CI 3.7% to 14.9%). No significant correlation with previously reported risk factors could be found, although a higher rate of ischemic strokes (four out of five) in the posterior circulation was recorded. In patients with intracranial stenosis who experience recurrent ischemic events despite best medical treatment, ICAS, using the balloon-expandable Pharos Vitesse stent, may still be considered as an individual treatment option in high-volume neurovascular centers.
    Journal of neurointerventional surgery 02/2014; · 1.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Relapsing symptoms post herpes simplex virus 1 (HSV) encephalitis (HSVE) usually occur a few weeks after viral therapy and represent either 1) a true viral relapse of HSVE (CSF PCR positive for HSV, new necrotic lesions on brain MRI, and response to acyclovir therapy) or 2) a disorder postulated to be immune-mediated (CSF negative for HSV, no new necrotic lesions, and no response to acyclovir).(1,2) It has been suggested that this immune-mediated disorder may be related to NMDA receptor (NMDAR) antibodies,(3) and we recently reported a child in whom relapsing symptoms post HSVE were the presentation of anti-NMDAR encephalitis.(4) We report an adult with this disorder, demonstrate that synthesis of NMDAR antibodies began after HSVE, and show that relapsing symptoms were due to steroid-responsive anti-NMDAR encephalitis.
    Neurology 10/2013; · 8.25 Impact Factor
  • M Rosenkranz, C Gerloff
    [Show abstract] [Hide abstract]
    ABSTRACT: Carotid artery stenting is associated with the risk of periprocedural stroke. Moreover, modern magnetic resonance (MR) imaging techniques have found high rates of clinically silent ischemic brain lesions on post-treatment diffusion-weighted MR imaging (DWI) scans. The clinical significance of procedure-related DWI lesions, however, is still a matter of debate. This review article considers the frequency, location and pathophysiology of new DWI lesions on post-treatment MR images and summarizes available data on their clinical significance.
    The Journal of cardiovascular surgery 02/2013; 54(1):93-9. · 1.51 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: The two most prevalent forms of neuronal ceroid lipofuscinosis (NCL) are the juvenile form (Batten disease, CLN3) and late infantile form (Jansky-Bielschowsky disease, CLN2). The aim of this study was to compare quantitative T2-values of brain tissue in CLN2 and CLN3 patients with reference values from age-matched normal subjects. METHODS: Twenty-three CLN2 (n = 6) and CLN3 (n = 17) patients (m:f = 11:12) underwent MRI examination including a multiecho T2 sequence. Quantitative T2-values were measured in six defined regions of interest (ROIs) in the calculated quantitative T2 maps within the white matter (WM) and gray matter (GM). The extracted quantitative T2-values were compared with reference values from healthy children and young adults. Informed consent was obtained from the patients or their parents for all patients. RESULTS: Statistical analysis revealed elevated quantitative T2-values in nearly all ROIs placed in the WM of the CLN2 patients. In contrast to this finding, no significant differences were found for the quantitative T2-values of the CLN3 patients compared to the age-matched healthy controls in any of the defined WM ROIs. Both groups exhibited no significant alterations of the quantitative T2-values in the GM ROIs compared to the healthy subjects. CONCLUSION: Alterations of quantitative T2-values in the cerebral WM may not be a reliable sign to confirm the diagnosis in CLN3 patients but could prove valuable for diagnosis confirmation, follow-up examinations, and longitudinal monitoring of the disease progression in CLN2 patients.
    Clinical neuroradiology. 12/2012;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: The physical background of diffusion phenomena in intracranial cysts is unclear in some cases. To evaluate a potential dependency of proton diffusion on the concentration of proteins in cystic lesions we investigated the correlation of diffusion weighted imaging (DWI) and magnetization transfer ratio imaging (MTR) in intracranial cystic pathologies in vivo and in vitro with protein solutions.Materials and Methods: 21 patients (14 male/7 female) with intracranial cystic lesions underwent preoperative MRI (1.5 T) including MTR and DWI sequences. For comparison a series of samples with declining concentration of albumin was investigated in vitro with a 7 T animal scanner. Results: In the patients examination mean ADC values were 1.93 × 10-3 mm2/sec and mean MTR values were 0.2. Mean ADC value of the albumin solutions was 0.22 × 10-3 mm2/sec and mean MTR was 0.12. ADC and MTR values showed a strong negative correlation in the patients (Spearman's rank correlation rs = -0.80, p < 0.01) and a very strong negative correlation in the in vitro examinations (rs = -1.0, p < 0.01).Conclusion: The strong negative correlation of ADC and MTR values suggest a strong influence of proteins on proton diffusion in intracranial cysts. The phenomena can be explained by macromelecules that bind nearby protons in their vicinity.
    RöFo - Fortschritte auf dem Gebiet der R 10/2012; · 2.76 Impact Factor
  • Clinical neurology and neurosurgery 10/2012; · 1.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES: Fluid-attenuated inversion recovery imaging (FLAIR) has been suggested as a surrogate marker of lesion age in acute ischemic stroke. In a subgroup analysis, we evaluated whether the extent of perfusion deficit influences FLAIR lesion visibility and thus plays a role as a confounding variable in the interpretation of FLAIR images. METHODS: A subgroup of patients from a previous study evaluating the use of FLAIR imaging as a surrogate marker of lesion age within the first 6 hours of ischemic stroke were examined to determine the influence of the amount of perfusion deficit on FLAIR lesion visibility. RESULTS: N= 48 patients were included into the analysis. In positive and negative FLAIR lesion cases the extent of perfusion deficits did not differ significantly (150 mL vs. 197 mL, P= .730) nor influenced FLAIR visibility independently. In contrast, diffusion weighted imaging (DWI) lesion volumes were larger (34 mL vs. 14 mL, P= .008) and time from symptom onset longer (180 vs. 120 minute, P= .071) in FLAIR-positive cases. CONCLUSION: Visibility of FLAIR lesions in acute stroke imaging is influenced by lesion size and time from symptom onset to MRI, but not by the amount of perfusion deficit calculated by time-to-peak (TTP) measurements. J Neuroimaging 2012;XX:1-4.
    Journal of neuroimaging: official journal of the American Society of Neuroimaging 07/2012; · 3.36 Impact Factor
  • Source
    Carsten Buhmann, Michael Rosenkranz
    [Show abstract] [Hide abstract]
    ABSTRACT: Aktuell werden etwa 40 Prozent aller Parkinsonpatienten vom Hausarzt behandelt, so dass der Allgemeinmediziner und hausärztlich tätige Internist mit Diagnostik, Therapie und potenziellen Wechselwirkungen der Parkinsonmedika-tion mit anderen Arzneimitteln vertraut sein sollte. D er M. Parkinson (syn. idiopathisches Parkinsonsyndrom) ist eine häufige neurodegenerative und progredient ver-laufende Systemerkrankung des zentralen, aber auch des peripheren und autonomen Nervensystems. Bei 60 – 70 Prozent der Pa-tienten tritt die Erkrankung nach dem 70. Lebensjahr auf. Aufgrund der epidemiolo-gischen Entwicklung ist davon auszuge-hen, dass sich in Deutschland die Zahl der Betroffenen von heute 250 000 – 400 000 bis 2030 verdoppeln wird. Die Diagnose eines M. Parkinson kann meist anhand einer sorgfältigen Anamnese und des klinischen Befundes ohne weitere Zusatzuntersuchungen gestellt werden. Schwierig kann die differenzialdiagnosti-sche Abgrenzung zu atypischen oder symp-tomatischen Parkinsonsyndromen sein. Hier kommen diagnostische Verfahren wie Schellong-oder Riechtest, Computer-oder Kernspintomografie, Hirnparenchymsono-grafie der Substantia nigra oder nuklear-medizinische Verfahren zum Einsatz. Bei diagnostischer Unsicherheit empfiehlt sich die Vorstellung bei einem mit Parkinson-syndromen vertrauten Neurologen. Die medikamentöse Therapie wird in-dividuell unter Berücksichtigung von Al-ter des Patienten, Krankheitsstadium so-wie Begleiterkrankungen gestaltet. In der Frühphase kann medikamentös meist eine Symptomkontrolle erreicht werden. In dieser Phase geht es in erster Linie da-rum, neben einer nebenwirkungsarmen optimalen Behandlung mittel-und lang-fristig medikamentös induzierte uner-wünschte Wirkungen zu vermeiden. Im fortgeschrittenem Stadium der Er-krankung ist die Therapie durch medika-mentös und krankheitsbedingte Kompli-kationen erschwert und fokussiert auf die Reduzierung motorischer Wirkungs-schwankungen, der Behandlung nicht-motorischer Symptome wie Depression, Demenz, Halluzinationen, autonomer Funktionsstörungen oder Schlafstörun-gen, sowie der Reduzierung medikamen-tös induzierter Nebenwirkungen. Hier ist eine begleitende fachärztliche Behandlung unbedingt anzuraten. Trotz unzureichen-der Datenlage sind in der Spätphase der Erkrankung Physiotherapie, Logopädie, Ergotherapie und psychosoziale Unterstüt-zung ein fester Bestandteil der Therapie.
    Der Hausarzt. 06/2012; 11:48-51.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Low recanalization rates and poor clinical outcome have been reported after intravenous thrombolysis (IV-tPA) in carotid-T occlusion (CTO). We studied clinical outcome and imaging findings of MRI-based intravenous thrombolysis in CTO. Data of patients with acute ischemic stroke and CTO treated with IV-tPA within 6 h of symptom onset based on MRI criteria were retrospectively analyzed. Vessel occlusion was defined based on MR angiography. Acute diffusion and perfusion lesion volumes and final infarct volumes after 3-7 days were delineated. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the neurological deficit on admission. Recanalization was evaluated after 24 h. Clinical outcome was assessed using the modified Rankin Scale (mRS) after 90 days. Clinical and imaging data were compared to patients with middle cerebral artery main stem occlusion (MCAO). A total of 20 patients with CTO and 51 patients with MCAO were studied. Onset to treatment time, NIHSS on admission, initial diffusion and perfusion lesion volumes, and recanalization rates after 24 h were similar between groups. Final infarct volume was larger for CTO (82 vs. 30 ml, p = 0.006). Although overall outcome was not significantly different between groups (p = 0.251), independent outcome (mRS 0-2) tended to be less frequent in CTO (17 vs. 39 %), while poor outcome (mRS 4-6) appeared more common (72 vs. 43 %). The proportion of patients with good clinical outcome after intravenous thrombolysis in CTO is small. Moreover, final infarct volume is larger and clinical outcome appears to be worse compared to MCAO.
    Journal of Neurology 03/2012; 259(10):2141-6. · 3.58 Impact Factor
  • Source
    Carsten Buhmann, Michael Rosenkranz
    Der Hausarzt. 01/2012; 06(11):48-51.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Carotid stenting carries a risk of periprocedural stroke. We aimed at determining predictors of cerebral ischemic events associated with stenting for symptomatic carotid stenosis. 127 patients who had been studied by diffusion-weighted MR imaging (DWI) before and on the day after carotid stenting were included. Six clinical variables and 5 variables characterizing the target carotid artery and aortic atherosclerosis were analyzed as potential risk factors for new ipsilateral DWI lesions after stenting. Among all variables assessed, only age, length of stenosis and carotid intima-media thickness (IMT) significantly modified the risk of new lesions after stenting. Age ≥68 years, stenosis ≥15 mm and IMT ≥1.3 mm were identified as the best thresholds to predict new lesions. In the subgroup of patients ≥68 years with carotid stenosis ≥15 mm in length and IMT ≥1.3 mm, the risk of new lesions was markedly higher than in patients to whom no more than two of these factors applied (odds ratio 7.250, 95% CI 1.612-34.513, p = 0.005). The use of this simple predictive model correctly identified patients who had new lesions after stenting with high specificity (0.96) and a negative predictive value (0.83), while the positive predictive value was moderate (0.60) and sensitivity was low (0.23). The risk of stenting for symptomatic carotid stenosis may vary with clinical and morphological patient characteristics. Further research is needed to validate these results and to evaluate the safety of stenting versus endarterectomy in specific patient subgroups.
    Cerebrovascular Diseases 11/2011; 33(1):30-6. · 2.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Many patients with stroke are precluded from thrombolysis treatment because the time from onset of their symptoms is unknown. We aimed to test whether a mismatch in visibility of an acute ischaemic lesion between diffusion-weighted MRI (DWI) and fluid-attenuated inversion recovery (FLAIR) MRI (DWI-FLAIR mismatch) can be used to detect patients within the recommended time window for thrombolysis. In this multicentre observational study, we analysed clinical and MRI data from patients presenting between Jan 1, 2001, and May 31, 2009, with acute stroke for whom DWI and FLAIR were done within 12 h of observed symptom onset. Two neurologists masked to clinical data judged the visibility of acute ischaemic lesions on DWI and FLAIR imaging, and DWI-FLAIR mismatch was diagnosed by consensus. We calculated predictive values of DWI-FLAIR mismatch for the identification of patients with symptom onset within 4·5 h and within 6 h and did multivariate regression analysis to identify potential confounding covariates. This study is registered with ClinicalTrials.gov, number NCT01021319. The final analysis included 543 patients. Mean age was 66·0 years (95% CI 64·7-67·3) and median National Institutes of Health Stroke Scale score was 8 (IQR 4-15). Acute ischaemic lesions were identified on DWI in 516 patients (95%) and on FLAIR in 271 patients (50%). Interobserver agreement for acute ischaemic lesion visibility on FLAIR imaging was moderate (κ=0·569, 95% CI 0·504-0·634). DWI-FLAIR mismatch identified patients within 4·5 h of symptom onset with 62% (95% CI 57-67) sensitivity, 78% (72-84) specificity, 83% (79-88) positive predictive value, and 54% (48-60) negative predictive value. Multivariate regression analysis identified a longer time to MRI (p<0·0001), a lower age (p=0·0009), and a larger DWI lesion volume (p=0·0226) as independent predictors of lesion visibility on FLAIR imaging. Patients with an acute ischaemic lesion detected with DWI but not with FLAIR imaging are likely to be within a time window for which thrombolysis is safe and effective. These findings lend support to the use of DWI-FLAIR mismatch for selection of patients in a future randomised trial of thrombolysis in patients with unknown time of symptom onset. Else Kröner-Fresenius-Stiftung, National Institutes of Health.
    The Lancet Neurology 11/2011; 10(11):978-86. · 23.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Stroke magnetic resonance imaging with perfusion and diffusion weighting has shown its potential to select patients likely to benefit from intravenous thrombolysis with tissue-type plasminogen activator (IV-tPA). We aimed to determine the predictors of favorable outcome in magnetic resonance imaging-selected, acute stroke patients treated with IV-tPA. We analyzed the data of acute ischemic stroke patients from a prospective, multicenter, observational study of magnetic resonance imaging-based IV-tPA treatment initiated ≤6 hours from symptom onset. Neurologic deficit on admission was assessed by the National Institutes of Health Stroke Scale. Clinical outcome was assessed after 90 days according to the modified Rankin Scale. Favorable outcome was defined as a modified Rankin Scale score of 0 to 1. Patients were compared regarding baseline parameters. Multivariate regression analysis was used to identify predictors of favorable outcome. Of 174 patients, 83 (48%) reached a favorable outcome. They were younger (median age, 62 versus 67 years; P=0.001), had a lower National Institutes of Health Stroke Scale score on admission (median, 11 versus 15; P<0.001), and had smaller diffusion-weighted imaging lesions (median, 12.9 versus 20 mL; P=0.001). Perfusion-weighted imaging lesion volumes and onset-to-treatment time were comparable between the groups. Age (P=0.017), National Institutes of Health Stroke Scale score on admission (P<0.001), and diffusion-weighted imaging lesion volume (P=0.047) were identified as independent predictors of favorable outcome. A lower age, lower National Institutes of Health Stroke Scale score on admission, and smaller pretreatment diffusion-weighted imaging lesion volume were found to be associated with a favorable outcome after treatment with IV-tPA. Pretreatment perfusion lesion volume and onset-to-treatment time were not associated with outcome when patients were selected for IV-tPA by magnetic resonance imaging within 6 hours of symptom onset.
    Stroke 03/2011; 42(5):1251-4. · 6.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Carotid artery stenting (CAS) is associated with the risk of periprocedural embolic events. The procedural risk may vary with plaque characteristics. We aimed at determining the impact of carotid plaque surface irregularity on the risk of cerebral embolism during CAS. Solid microembolic signals (MES) during CAS for symptomatic carotid stenosis were assessed by means of dual-frequency transcranial Doppler ultrasound. Study endpoint was the number of solid MES during CAS in 12 patients with irregular carotid stenosis compared to 12 matched patients with smooth carotid stenosis. A total of 438 solid MES were detected. The cumulative number of solid MES was 329 in patients with irregular plaques and 109 in those with smooth plaques. The proportion of subjects in whom solid MES were detected was higher in the irregular plaque group (11/12) than in the smooth plaque group (5/12) (p = 0.030). The numbers of solid MES per CAS procedure and per hour of CAS procedure were both higher in patients with irregular plaques than in those with smooth plaques (p = 0.008 and 0.015, respectively). Carotid plaque surface irregularity predicts solid cerebral embolism during stenting of symptomatic carotid artery stenosis.
    Cerebrovascular Diseases 01/2011; 32(2):163-9. · 2.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Granulocyte colony-stimulating factor (G-CSF) is a promising stroke drug candidate. The present phase IIa study assessed safety and tolerability over a broad dose range of G-CSF doses in acute ischemic stroke patients and explored outcome data. Four intravenous dose regimens (total cumulative doses of 30-180 μg/kg over the course of 3 days) of G-CSF were tested in 44 patients in a national, multicenter, randomized, placebo-controlled dose escalation study (NCT00132470; www.clinicaltrial.gov). Main inclusion criteria were a 12-hour time window after stroke onset, infarct localization to the middle cerebral artery territory, a baseline National Institutes of Health Stroke Scale range of 4 to 22, and presence of diffusion-weighted imaging/perfusion-weighted imaging mismatch. Concerning the primary safety end points, we observed no increase of thromboembolic events in the active treatment groups, and no increase in related serious adverse events. G-CSF led to expected increases in neutrophils and monocytes that resolved rapidly after end of treatment. We observed a clinically insignificant drug-related decrease of platelets. As expected from the low number of patients, we did not observe significant differences in clinical outcome in treatment vs. placebo. In exploratory analyses, we observed an interesting dose-dependent beneficial effect of treatment in patients with DWI lesions > 14-17 cm³. We conclude that G-CSF was well-tolerated even at high dosages in patients with acute ischemic stroke, and that a substantial increase in leukocytes appears not problematic in stroke patients. In addition, exploratory analyses suggest treatment effects in patients with larger baseline diffusion-weighted imaging lesions. The obtained data provide the basis for a second trial aimed to demonstrate safety and efficacy of G-CSF on clinical end points.
    Stroke 11/2010; 41(11):2545-51. · 6.16 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We describe the regional distribution of acute perfusion, diffusion, and final infarct lesions in middle cerebral artery (MCA) trunk occlusion. A total of 31 patients with acute ischemic stroke and MCA trunk occlusion were studied by multiparametric magnetic resonance imaging. Probabilistic maps of lesion distribution were generated. The probability of initial and final infarcts was highest in the central MCA region with decreasing probability toward the periphery where the probability of the tissue at risk of infarction to be saved was highest. The probability of brain regions being involved in acute diffusion lesions and evolving into or escaping from the final infarct relates to the anatomy of arterial blood supply.
    Journal of cerebral blood flow and metabolism: official journal of the International Society of Cerebral Blood Flow and Metabolism 10/2010; 31(1):36-40. · 5.46 Impact Factor
  • Michael Rosenkranz, Christian Gerloff
    [Show abstract] [Hide abstract]
    ABSTRACT: Carotid artery stenosis is associated with the risk of stroke, myocardial infarction, and vascular death. In selected patients, revascularization of carotid narrowing by endarterectomy may reduce the risk of stroke distal to the stenosis. Carotid artery stenting has evolved as a potential alternative to endarterectomy. Four randomized clinical trials comparing safety and efficacy of endarterectomy versus stenting of symptomatic carotid stenosis have been published in recent years, but there remains some uncertainty about the implications of these trials for clinical routine. Both carotid stenting and endarterectomy are based on different treatment strategies which may result in different specific risk factors associated with each procedure. Hence, the procedural risk of either modality varies not only with the skills of the surgeon or the interventionalist but may depend on patient characteristics. It appears that the most important question is not whether one revascularization modality is superior but for which patient one modality is better than the other. A comprehensive diagnostic workup of patients with carotid stenosis based on a broad panel of covariates that affect the risk of vascular events may improve selection of patients for carotid revascularization and may help to decide for whom one revascularization modality is likely to be better than the other.
    Neuroradiology 07/2010; 52(7):619-28. · 2.70 Impact Factor
  • Michael Rosenkranz, Christian Gerloff
    Circulation 05/2010; 121(18):e395-6. · 15.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Carotid-artery stenting (CAS) may be complicated by stroke. We aimed to determine predictors of procedure-related ischemic events. We analyzed new ischemic lesions in diffusion-weighted MRI (DWI) after CAS in 147 patients with symptomatic high-grade carotid stenosis. Nine covariates were assessed as potential risk factors for new lesions in DWI: age, gender, hypertension, diabetes, dyslipidemia, smoking status, severity of stenosis, side of intervention and carotid intima-media thickness (IMT). From the nine covariates assessed, only age and IMT were independently associated with new DWI lesions. An age of 68 years and an IMT of 1.5 mm gave the best separation between high- and low-risk populations. The subgroup of patients <68 years who had an IMT ≤1.5 mm had the lowest rate of new DWI lesions (11.3%). This rate was greater in patients ≥68 years (30.0%; odds ratio, OR, 3.4; 95% confidence interval, CI, 1.1-10.8) and in patients with an IMT >1.5 mm (36.4%; OR 4.5; 95% CI 1.2-17.0) and was particularly high in patients aged ≥68 years with IMT >1.5 mm (69.6%; OR 18.0; 95% CI 4.8-71.9). Older age and greater IMT are independently associated with the risk of CAS-related ischemic events. This risk is particularly high in those patients in whom older age and greater IMT coincide.
    Cerebrovascular Diseases 01/2010; 30(6):567-72. · 2.81 Impact Factor

Publication Stats

473 Citations
181.60 Total Impact Points

Institutions

  • 2003–2014
    • University Medical Center Hamburg - Eppendorf
      • Department of Neurology
      Hamburg, Hamburg, Germany
  • 2004–2012
    • University of Hamburg
      • • Department of Neurology
      • • Department of Diagnostic and Interventional Neuroradiology
      Hamburg, Hamburg, Germany
  • 2006
    • Universitätsklinikum Freiburg
      • Department of Neurology and Neurophysiology
      Freiburg, Lower Saxony, Germany