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This report presents the disease incidence and prevalence and surgical procedure volumes for selected neurological diseases/disorders and procedures in Germany; incidence and prevalence figures are compared with those of the Benelux countries
This report presents the disease incidence and prevalence and surgical procedure volumes for selected neurological diseases/disorders and procedures in Germany; incidence and prevalence figures are compared with those of the Benelux countries (Belgium, Luxembourg, and the Netherlands), the Nordic countries (Denmark, Finland, Norway, and Sweden), and the European Union (EU) countries of Austria, Belgium, Bulgaria, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the United Kingdom (U.K.). Among the diseases/disorders covered by this report are Alzheimer’s disease, bipolar disorder, depression, epilepsy, multiple sclerosis (MS), Parkinson’s disease, schizophrenia, and stroke.
1. OVERVIEW OF NEUROLOGICAL DISORDERS…………………………………. 1-1
1.1 Alzheimer’s Disease……………………………………………………………….. 1-1
1.2 Amyotrophic Lateral Sclerosis ………………………………………………….. 1-3
1.3 Arteriovenous Malformation……………………………………………………… 1-4
1.4 Bipolar Disorder……………………………………………………………………… 1-5
1.5 Depression ……………………………………………………………………………. 1-6
1.6 Epilepsy………………………………………………………………………………… 1-6
1.7 Huntington’s Disease………………………………………………………………. 1-7
1.8 Hydrocephalus……………………………………………………………………….. 1-8
1.9 Multiple Sclerosis……………………………………………………………………. 1-9
1.10 Parkinson’s Disease……………………………………………………………… 1-10
1.11 Schizophrenia………………………………………………………………………. 1-11
1.12 Stroke…………………………………………………………………………………. 1-12
Exhibit 1-1: Germany, Neurosurgery, Procedure Volumes Forecast, by Type, 2010-2016………………………………………………………………… 1-2
Exhibit 1-2: Germany, Neurological Diseases/Disorders, Incidence and Prevalence ……………………………………………………… 1-14
2. NEUROLOGICAL AND PSYCHIATRIC DISORDERS………………………….. 2-1
2.1 Alzheimer’s Disease and Dementia…………………………………………… 2-1
2.1.1 Etiology…………………………………………………………………… 2-1
2.1.2 Epidemiology…………………………………………………………… 2-2
2.2 Amyotrophic Lateral Sclerosis ………………………………………………….. 2-3
2.2.1 Etiology…………………………………………………………………… 2-3
2.2.2 Epidemiology…………………………………………………………… 2-7
2.3 Bipolar Disorder……………………………………………………………………… 2-8
2.3.1 Etiology…………………………………………………………………… 2-8
2.3.2 Epidemiology…………………………………………………………. 2-10
2.4 Cerebrovascular Disorders…………………………………………………….. 2-11
2.4.1 Arteriovenous Malformation……………………………………… 2-11
2.4.1.1 Etiology ………………………………………………….. 2-13
2.4.1.2 Epidemiology…………………………………………… 2-13
2.4.2 Stroke…………………………………………………………………… 2-14
2.4.2.1 Etiology ………………………………………………….. 2-14
2.4.2.2 Epidemiology…………………………………………… 2-17
2.5 Depression ………………………………………………………………………….. 2-19
2.5.1 Etiology…………………………………………………………………. 2-19
2.5.2 Epidemiology…………………………………………………………. 2-20
2.6 Epilepsy………………………………………………………………………………. 2-21
2.6.1 Etiology…………………………………………………………………. 2-23
2.6.2 Epidemiology…………………………………………………………. 2-24
2.7 Huntington’s Disease…………………………………………………………….. 2-25
2.7.1 Etiology…………………………………………………………………. 2-25
2.7.2 Epidemiology…………………………………………………………. 2-27
2.8 Hydrocephalus……………………………………………………………………… 2-27
2.8.1 Etiology…………………………………………………………………. 2-29
2.8.2 Epidemiology…………………………………………………………. 2-29
2.9 Multiple Sclerosis………………………………………………………………….. 2-30
2.9.1 Etiology…………………………………………………………………. 2-33
2.9.2 Epidemiology…………………………………………………………. 2-34
2.10 Myasthenia Gravis………………………………………………………………… 2-37
2.10.1 Etiology…………………………………………………………………. 2-37
2.10.2 Epidemiology…………………………………………………………. 2-38
2.11 Parkinson’s Disease……………………………………………………………… 2-38
2.11.1 Etiology…………………………………………………………………. 2-41
2.11.2 Epidemiology…………………………………………………………. 2-42
2.12 Schizophrenia………………………………………………………………………. 2-42
2.12.1 Etiology…………………………………………………………………. 2-44
2.12.2 Epidemiology…………………………………………………………. 2-45
Exhibit 2-1: 2010, Europe, Diagnosed and Undiagnosed Dementia,
Incidence Rates, by Age and Gender………………………………………… 2-4
Exhibit 2-2: 2010, Europe, Diagnosed and Undiagnosed Dementia,
Prevalence Rates, by Age and Gender ……………………………………… 2-5
Exhibit 2-3: 2010, Germany and Europe, Alzheimer’s Disease, Comparative Incidence and Prevalence…………………………………….. 2-6
Exhibit 2-4: 2010, Germany and Europe, Amyotrophic Lateral Sclerosis,
Comparative Incidence and Prevalence…………………………………….. 2-9
Exhibit 2-5: 2010, Germany and Europe, Bipolar Disorder,
Comparative Incidence and Prevalence…………………………………… 2-12
Exhibit 2-6: 2010, Germany and Europe, Arteriovenous Malformation,
Comparative Incidence and Prevalence…………………………………… 2-15
Exhibit 2-7: 2010, Germany and Europe, Stroke,
Comparative Incidence and Prevalence…………………………………… 2-18
Exhibit 2-8: 2010, Germany and Europe, Depression,
Comparative Prevalence ……………………………………………………….. 2-22
Exhibit 2-9: 2010, Germany and Europe, Epilepsy,
Comparative Incidence and Prevalence…………………………………… 2-26
Exhibit 2-10: 2010, Germany and Europe, Huntington’s Disease,
Comparative Incidence and Prevalence…………………………………… 2-28
Exhibit 2-11: 2010, Germany and Europe, Hydrocephalus,
Comparative Incidence and Prevalence…………………………………… 2-31
Exhibit 2-12: 2010, Germany and Europe, Multiple Sclerosis,
Comparative Incidence and Prevalence…………………………………… 2-36
Exhibit 2-13: 2010, Germany and Europe, Myasthenia Gravis,
Comparative Incidence and Prevalence…………………………………… 2-39
Exhibit 2-14: 2010, Germany and Europe, Parkinson’s Disease,
Comparative Incidence and Prevalence…………………………………… 2-43
Exhibit 2-15: 2010, Germany and Europe, Schizophrenia,
Comparative Incidence and Prevalence…………………………………… 2-46
3. NEUROSURGICAL PROCEDURES ………………………………………………….. 3-1
3.1 The Brain………………………………………………………………………………. 3-1
3.1.1 The Cerebrum …………………………………………………………. 3-1
3.1.2 The Cerebellum……………………………………………………….. 3-2
3.1.3 The Brainstem …………………………………………………………. 3-2
3.1.4 The Meninges………………………………………………………….. 3-4
3.1.5 The Ventricular System …………………………………………….. 3-4
3.1.6 Cerebrospinal Fluid ………………………………………………….. 3-6
3.1.7 The Hypothalamus …………………………………………………… 3-6
3.1.8 The Pineal Gland……………………………………………………… 3-6
3.1.9 The Pituitary Gland…………………………………………………… 3-8
3.2 Selected Diseases/Disorders of the Central Nervous System and the Peripheral Nervous System………………………………………….. 3-8
3.2.1 Hydrocephalus ………………………………………………………… 3-8
3.2.2 Movement, Seizure, and Tremor Disorders………………… 3-10
3.2.2.1 Alzheimer’s Disease…………………………………. 3-10
3.2.2.2 Epilepsy………………………………………………….. 3-12
3.2.2.3 Multiple Sclerosis …………………………………….. 3-14
3.2.2.4 Parkinson’s Disease…………………………………. 3-15
3.2.2.5 Deep Brain Stimulation……………………………… 3-16
3.2.2.6 Stereotactic Radiosurgery …………………………. 3-18
3.2.3 Traumatic Brain Injury …………………………………………….. 3-19
3.3 The Cerebrovascular System and Selected Diseases/Disorders …. 3-22
3.3.1 The Arterial System………………………………………………… 3-22
3.3.2 The Venous System ……………………………………………….. 3-25
3.3.3 Aneurysm ……………………………………………………………… 3-25
3.3.4 Arteriovenous Malformation……………………………………… 3-27
3.3.5 Stroke…………………………………………………………………… 3-30
Exhibit 3-1: Structural Relationship between the Cerebrum, Cerebellum, and Brainstem ……………………………………………………………………….. 3-3
Exhibit 3-2: Structure of the Meninges ……………………………………………………….. 3-5
Exhibit 3-3: Ventricles of the Brain …………………………………………………………….. 3-7
Exhibit 3-4: Germany, Ventricular Shunting and Ventriculostomy,
Procedure Volumes Forecast, 2010-2016 ………………………………… 3-11
Exhibit 3-5: Germany, Deep Brain Stimulation and Stereotactic Radiosurgery,
Procedure Volumes Forecast, 2010-2016 ………………………………… 3-20
Exhibit 3-6: Germany, Evacuation of Subdural Hematoma,
Procedure Volumes Forecast, 2010-2016 ………………………………… 3-23
Exhibit 3-7: Germany, Cerebral Aneurysm Clipping,
Procedure Volumes Forecast, 2010-2016 ………………………………… 3-28
Exhibit 3-8: Germany, Arteriovenous Malformation Embolization,
Procedure Volumes Forecast, 2010-2016 ………………………………… 3-31
Exhibit 3-9: Germany, Carotid Endarterectomy and Carotid Artery Stenting,
Procedure Volumes Forecast, 2010-2016 ………………………………… 3-35
Figure: 2010, Germany and Europe, Alzheimer’s Disease, Comparative Incidence and Prevalence
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