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September 17, 2013; 81 (12) Views & Reviews

Recognition and management of stroke in young adults and adolescents

Aneesh B. Singhal, José Biller, Mitchell S. Elkind, Heather J. Fullerton, Edward C. Jauch, Steven J. Kittner, Deborah A. Levine, Steven R. Levine
First published August 14, 2013, DOI: https://doi.org/10.1212/WNL.0b013e3182a4a451
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Article Information

vol. 81 no. 12 1089-1097
DOI: 
https://doi.org/10.1212/WNL.0b013e3182a4a451
PubMed: 
23946297
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received January 28, 2013
  • Accepted in final form June 17, 2013
  • First Published August 14, 2013.

Article Versions

Copyright & Usage: 
© 2013 American Academy of Neurology

Author Disclosures

    1. Aneesh B. Singhal, MD,
    2. José Biller, MD,
    3. Mitchell S. Elkind, MD, MS, MPhil,
    4. Heather J. Fullerton, MD,
    5. Edward C. Jauch, MD,
    6. Steven J. Kittner, MD,
    7. Deborah A. Levine, MD, MPH and
    8. Steven R. Levine, MD
  1. Aneesh B. Singhal, MD,
    2. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Associate Editor, Medical Gas Research (2010-present)

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. My wife is an employee of Biogen-Idec, Inc.

    Consultancies:

    1. Biogen-Idec, Inc.

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. Event Adjudicator, Thrombolysis in Myocardial Infarction (TIMI) Trial Group.

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. Research support from Pfizer, Inc. and Photothera, Inc.

    Research Support, Government Entities:

    1. NIH-NINDS grants R01NS051412 (PI), R21NS077442 (PI), R01NS059775 (co-I), P50NS044148 (site PI) Stock/Stock Options, Medical Equipment & Materials: My wife holds employee stock and stock options in Vertex Pharmaceuticals. Inc and Biogen-Idec, Inc.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. I have served as a medicolegal expert witness for individual cases concerning stroke. Signature: /abs2/ Date: 06/10/2013

  2. José Biller, MD,
    3. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Editor of Journal of Stroke and Cerebrovascular Diseases, Chief Editor of Frontiers in Neurology

    Patents:

    1. NONE

    Publishing Royalties:

    1. Received published royalties for: Practical Neurology 4th Edition, LWW Wolters Kluwer, Localization in Clinical Neurology 6th Edition, LWW Wolters Kluwer, DVD Practical Neurology, LWW Wolters Kluwer, Concise Neurology, Espay and Biller, LWW Wolters Kluwer, Toole's Cerebrovascular Disorders 6th Ed, Cambridge Medicine, Evidence based Management of Stroke, tfm Publishing Limited, Castle Hill Barnes, UK, DeMyer's. The Neurologic Examination 6th Edition, McGraw Hill, Stroke in Children and Young Adults,2nd Edition, Saunders

    Employment, Commercial Entity:

    1. Loyola University Medical Center, Maywood, IL

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  3. Mitchell S. Elkind, MD, MS, MPhil,
    4. Scientific Advisory Boards:

    1. (1) Jarvik Heart, Clinical Events Committee member, adjudicating events in clinical trial of artificial heart (2008-present); (2) Biogen IDEC, scientific advisory board, stroke trial design

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. (1) Neurology, Resident and Fellow Section editor, published by American Academy of Neurology (2007-present)

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. Columbia University

    Consultancies:

    1. (1) BMS-Pfizer Partnership, consultant regarding antithrombotics for stroke

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. (1) diaDexus, Inc: funding for biomarker research; (2) BMS-Sanofi Pharmaceutical Partnership: funding for biomarker research

    Research Support, Government Entities:

    1. (1) NIH/NINDS P50 NS049060, Project PI, 2004–2013; (2) NIH/NINDS R37 NS029993, Co-PI, 2008-2013; (3) NIH/NINDS 1R25 NS070697, PI, 2010–2015

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. (1) American Heart Association Founders Affiliate Board of Directors)(2008-present); (2) American Heart Association NY City Board of Directors (2011-present)

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. (1) GSK, Avandia and stroke litigation, 2009-2011; (2) Organon/Merck, NuvaRing and stroke litigation, 2009- present; (3) Novartis, aliskiren and stroke litigation, 2013- present

  4. Heather J. Fullerton, MD,
    5. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Cincinnati Children’s Hospital, OH, Speaker, 2010; Hospital for Sick Children, Toronto, Canada, Speaker, 2010; International Pediatric Neurology Master class, Bristol, England, Speaker, 2011

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. R01 NS062820HJ (PI) NIH/NINDS Vascular Effects of Infection in Pediatric Stroke (VIPS) 08/05/2009 - 07/31/2014; R01 NS062820-02S1(PI) NIH/NINDS Global Health Supplement to VIPS 08/01/2010 - 07/31/2011; K02 NS053883(PI) NIH/NINDS Independent Scientist Award The Role of Infection in Childhood Stroke 06/01/2006 - 08/31/2011 R01 HL096789-01RJ (Co-investigator) NIH/HSOD Prevention of Stroke after STOP (POST-STOP) 07/01/2009 - 06/30/2014

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. American Heart Association Established Investigator Award

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. Served as an expert witness for legal proceedings regarding children with stroke.

  5. Edward C. Jauch, MD,
    6. Scientific Advisory Boards:

    1. DSMB for NIH/NINDS FAST-Mag study

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Stroke, Editorial Board, 2011-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NIH/NINDS U01 NS052220 NIH/NINDS U01 NS054630

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  6. Steven J. Kittner, MD,
    7. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Editorial Board, Neuroepidemiology, 2000- present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NINDS: 1U01NS069208, Co-PI, 2010-2013 NINDS: R01NS069763-01, Site PI Veterans Affairs Merit Review Grant, PI, 2010-2012

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  7. Deborah A. Levine, MD, MPH and
    8. Scientific Advisory Boards:

    1. Member, Program Advisory Committee (PAC) of the Kaiser Permanente Northern California (KPNC) - University of California San Francisco (UCSF) Stroke Prevention/Intervention Research Program (SPIRP)

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. consultant (Cardiovascular Event Adjudicator) on the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial, a Randomized, Double- blind, Multi-center Clinical Trial. (NINDS 1U01S062835- 01A1; Johnston SC/Easton JD, Multiple PIs; 09/01/2009- 06/30/2016).

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. Grant Number P30DK092926 from the National Institute of Diabetes and Digestive and Kidney Diseases (Investigator) and by Grant Number K23AG040278 (PI Levine D) from the National Institute of Aging.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  8. Steven R. Levine, MD
    9. Scientific Advisory Boards:

    1. (1) Independent Medical/Safety Monitor for NINDS-funded IMS 3, FAST MAG, INSTINCT, and CLEAR-ER (2) Adjudication committee for NINDS-funded WARCEF

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. (1) Genentech-sponsored investigator meeting - travel expenses reimbursement in 2011

    Editorial Boards:

    1. (1) MEDLINK, Associate Editor, 1996-present (2) National Stroke Association, scientific content advisor,2011

    Patents:

    1. NONE

    Publishing Royalties:

    1. (1) Book: Transient Ischemic Attacks, Blackwell Futura, 2004

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Genentech study on cost-effectiveness of primary stroke centers, 2011 - consultant within a study group

    Speakers' Bureaus:

    1. (1)Medical Education Speakers Network, lecturer, 2008-2012 (2)NCME, lecturer, 2008-2011

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1)NIH-NHLBI 1R01 HL096944, principal investigator, 2009- 2013 (2) NIH-NINDS 1UO1 NS044364, Independent safety monitor, 2003 - 2012 (3) NIH-NINDS 1 U10 NS077378,PI, 2011 - 2017 (4) NIH-NINDS 1 U10 NS080377, PI, 2012 - 2017 (5) PCORI, Scientific PI, 2012-2014 (5) NIH-NINDS 1 R25 NS079211, MPI, 2012- 2017 (6) The Patient-Centered Outcomes Research Institute (PCORI) 1IP2PI000781, scientific PI, 2012-2014 (7) NIH-NIA 1 R01 AG040039, Co-I, 2011-2016 (8) NIH-NINDS 2 P50 NS044283, safety monitor, 2008-2013 (9) NIH-NINDS 2 U01 NS052220, independent medical monitor, 2005-2013

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  1. From the Department of Neurology (A.B.S.), Massachusetts General Hospital, Boston; Department of Neurology (J.B.), Loyola University Chicago, Maywood, IL; Department of Neurology (M.S.E.), College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York; Departments of Neurology and Pediatrics (H.J.F.), University of California San Francisco; Division of Emergency Medicine and Department of Neurosciences (E.C.J.), Medical University of South Carolina, Charleston; Department of Neurology (S.J.K.), Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine, Baltimore, MD; Departments of Internal Medicine and Neurology (D.A.L.), University of Michigan and Ann Arbor VA Medical Center, Ann Arbor, MI; and Departments of Neurology and Emergency Medicine (S.R.L.), SUNY Downstate College of Medicine and Medical Center, and Kings County Hospital Center, Brooklyn, NY.
  1. Correspondence to Dr. Singhal: asinghal{at}partners.org
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