Harald Schrader

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Harald Schrader (born September 24, 1944 ) is a German neurologist who discovered a new drug treatment for the prevention of migraines and for the improvement of accessory symptoms of the sleeping sickness narcolepsy . He has also made contributions to neurotraumatology , particularly in the area of cervical whiplash (ST) syndrome.

Life

Schrader was born near Munich to a Norwegian mother and a German father. He graduated from the Herderschule in Rendsburg in 1964, studied medicine at the Eppendorf University Hospital in Hamburg from 1964 to 1970 and worked under Mundinger from 1971 to 1973 as a research assistant in the neurosurgical clinic at the University of Freiburg im Breisgau . In 1973 he moved to Norway, where he received his specialist training as a neurologist from 1974 to 1980 under the direction of Refsum at the neurological department of the National University Hospital ( Rikshospitalet ). From 1981 to 1987 he was a professor at the neurological department of the Ullevål University Hospital in Oslo. From 1987 to 2009 he was full professor at the Technical and Natural Sciences University of Norway (NTNU) and senior physician in the neurological department of the University Hospital in Trondheim .

Research activity

Critically increased pressure inside the skull

From 1981 to 1985 he was able to clarify the main mechanism that leads to increased blood pressure, irregular breathing and a change in heart rate, the so-called Cushing reflex , when the pressure inside the skull is critically increased . Together with Zwetnow and Löfgren, he was able to demonstrate that with significantly increased blood pressure, the inside of the skull can tolerate swelling up to twice as much in terms of volume before irreversible brain damage occurs.

Narcolepsy

In 1984-85 he made the first controlled study that showed that a serotonin reuptake inhibitor (SSRI) can significantly improve accessory symptoms such as cataplexy , hallucinations and sleep paralysis of narcolepsy .

Migraine prevention

In 1996, while treating his own high blood pressure, he discovered that the drug he was using, the ACE inhibitor lisinopril , also made his migraines go away. The angiotensin II receptor antagonist candesartan had an equally good preventive effect after a dry cough occurred as a side effect of lisinopril. Subsequent controlled studies documented the equality with the best prophylactic drugs to date. There are fewer contraindications compared to beta blockers. Candesartan is now increasingly used as a first-line prophylactic in many countries.

Follow-up conditions after whiplash injuries

Due to the dramatic increase in the number of accident victims with chronic complaints after cervical whiplash in Norway at the end of the 80s / beginning of the 90s, Schrader got the idea to investigate the occurrence of this condition in an Eastern European country like Lithuania. In Lithuania at that time there was little or no awareness in the general population about possible consequential damage after HWS-ST and minimal possibilities for financial compensation. Under his leadership, Norwegian and Lithuanian neurologists conducted controlled studies between 1994 and 1998 to investigate the incidence of chronic cervical ST syndrome in Lithuanian accident victims. It was found that none of the total of 412 victims of a rear-end collision developed permanent, accident-related symptoms. After the publication of the first study in 1996 in the journal " The Lancet ", which attracted international attention, there were several letters to the editor criticizing the study design, but also acknowledging it. Fred Plum of New York University Hospital described the study as "an act of epidemiological genius". The Canadian psychiatry professor Malleson wrote in his book “Whiplash and other useful illnesses”: “Like frightful wikings from the past they had threatened to break havoc with the profitable whiplash industry”. There were violent protests by representatives of whiplash advocacy groups accusing Schrader of having insurance companies funded his study. Schrader had only received financial support from his University (NTNU) in Trondheim. After the publication of a prospective cohort study in 1999, no detailed, well-founded criticism or a similar carefully controlled study that contradicts the Lithuanian results has been published in international medical journals. In 2012 Schrader published a comprehensive study in the medical journal "Der Orthopäde" together with the German forensic doctor Eisenmenger and the head of the Norwegian National Headache Center, Stovner . The authors had searched the medical metadata base “Pubmed” in more than 1600 whiplash publications since 1996 for studies that were able to document the existence of the chronic cervical ST with a methodologically impeccable design. No job was identified.

Honors

  • 1976 Ragnar Forsberg legacy for young neurologists
  • 1985 Thomas W, Langfitts Prize for Studies on the Cushing Reflex (6th ICP International Conference, Glasgow, 1985)
  • 1997 Monrad-Krohns Prize for HWST-ST studies in Lithuania
  • 2001 Medal of Honor from the Central Norwegian newspaper Adresseavisen for the discovery of new migraine prevention

Individual evidence

  1. ^ Schrader et al .: Effects of prolonged supratentorial mass expansion on regional blood flow and cardiovascular parameters during the Cushing response. Acta Neurol Scand. 1985 Sep; 72 (3): 283-94
  2. ↑ Schrader et al .: Regional cerebral blood flow and CSF pressures during the Cushing response induced by an infratentorial expanding mass. Acta Neurol Scand. 1985 Sep; 72 (3): 273-82
  3. ^ Schrader et al .: Regional cerebral blood flow and CSF pressures during Cushing response induced by a supratentorial expanding mass. Acta Neurol Scand. 1985 Jun; 71 (6): 453-634
  4. ^ Schrader, Löfgren, Zwetnow. Influence of blood pressure on tolerance to an intracranial expanding mass. Acta Neurol Scand. 1985 Feb; 71 (2): 114-26
  5. ↑ Schrader et al .: The treatment of accessory symptoms in narcolepsy: A double-blind cross-over study of a selective serotonin re-uptake inhibitor (femoxetine) versus placebo. Acta Neurol Scand 1986 74 (4): 297-303
  6. ^ Schrader et al .: Prophylactic treatment of migraine with angiotensin converting enzyme inhibitor (lisinopril): randomized, placebo controlled, crossover study. BMJ. 2001 Jan 6; 322 (7277): 19-22
  7. ↑ Tronvik et al .: Prophylactic treatment of migraine with at angiotensin II receptor blocker: a randomized controlled trial. JAMA. 2003 Jan 1; 289 (1): 65-9
  8. ↑ Stovner et al .: A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomized, triple-blind, placebo-controlled, double cross-ove r study. Cephalalgia. 2013 Dec 11; 34 (7): 523-532
  9. ↑ https://www.mja.com.au/journal/2008/189/5/migraine-prophylaxis
  10. ↑ http://www.medscape.com/viewarticle/807383
  11. ^ Schrader et al .: Natural evolution of late whiplash syndrome outside the medicolegal context. The Lancet 1996; 199: 347: 1207-1211
  12. ↑ http://www.nytimes.com/1996/05/07/science/in-one-country-chronic-whiplash-is-uncompensated-and-unknown.html
  13. ↑ http://www.uh.edu/engines/epi1123.htm
  14. ↑ Jörg Blech: MEDICINE: Illnesses that heaven sends . In: Der Spiegel . No. 32 , 2004 ( online - Aug. 2, 2004 ).
  15. ↑ Freeman et al .: Late whiplash syndrome. The Lancet. 1996, 13; 348 (9020): 125; Author's answer 125-6
  16. ↑ Bjørgen: Late whiplash syndrome. The Lancet. 1996 Jul 13; 348 (9020): 124; Author's answer 125-6
  17. ↑ Plum: Whiplash revisited: without frills. Neurology Alert 1996 14/12; 92-93
  18. ↑ Ferrari. Whiplash encyclopedia: The facts and myths of whiplash. Aspen publishers 1999 ( ISBN 08342-1661-2 ) 8
  19. ↑ Malleson. Whiplash and other useful illnesses. Mcgill Queens Univ Pr 2002 ( ISBN 0-7735-2333-2 ) 33-35, 70-71
  20. ↑ Obelieniene et al .:  Pain after whiplash: a prospective controlled cohort study inception. J Neurol Neurosurg Psychiatry 1999; 66: 279-283
  21. ^ Schrader et al .: Questionable nosological validity of the chronic whiplash trauma syndrome. Orthopedist. 2012 41 (2): 147-52
personal data
SURNAME Schrader, Harald
BRIEF DESCRIPTION German neurologist
DATE OF BIRTH September 24, 1944