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November 22, 2016; 87 (21) Article

Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population

Jason Mackey, Jane C. Khoury, Kathleen Alwell, Charles J. Moomaw, Brett M. Kissela, Matthew L. Flaherty, Opeolu Adeoye, Daniel Woo, Simona Ferioli, Felipe De Los Rios La Rosa, Sharyl Martini, Pooja Khatri, Joseph P. Broderick, Mario Zuccarello, Dawn Kleindorfer
First published October 21, 2016, DOI: https://doi.org/10.1212/WNL.0000000000003353
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Article Information

vol. 87 no. 21 2192-2197
DOI: 
https://doi.org/10.1212/WNL.0000000000003353
PubMed: 
27770074
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received March 29, 2016
  • Accepted in final form August 11, 2016
  • First Published October 21, 2016.

Article Versions

Copyright & Usage: 
© 2016 American Academy of Neurology

Author Disclosures

    1. Jason Mackey, MD, MS,
    2. Jane C. Khoury, PhD,
    3. Kathleen Alwell, RN, BSN,
    4. Charles J. Moomaw, PhD,
    5. Brett M. Kissela, MD, MS,
    6. Matthew L. Flaherty, MD,
    7. Opeolu Adeoye, MD, MS,
    8. Daniel Woo, MD, MS,
    9. Simona Ferioli, MD,
    10. Felipe De Los Rios La Rosa, MD,
    11. Sharyl Martini, MD, PhD,
    12. Pooja Khatri, MD,
    13. Joseph P. Broderick, MD,
    14. Mario Zuccarello, MD and
    15. Dawn Kleindorfer, MD
  1. Jason Mackey, MD, MS,
    2. Scientific Advisory Boards:

    1. NONE

    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. 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. 1. NIH/NINDS R01 NS030678 2. NIH Loan Repayment Program

    Research Support, Academic Entities:

    1. 1. IUH Values Fund (VFR-365) 2. IU CTSI Project Development Team 3. IU CTSI KL2 award (NIH, UL1TR001108) 4. IUSM/IUH Strategic Research Initiative

    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

  2. Jane C. Khoury, PhD,
    3. Scientific Advisory Boards:

    1. NONE

    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. 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. NIH/NINDS R01 NS030678 lead biostatistician, 22 years

    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. Kathleen Alwell, RN, BSN,
    4. Scientific Advisory Boards:

    1. NONE

    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. 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. NIH/NINDS R01 NS30678

    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

  4. Charles J. Moomaw, PhD,
    5. Scientific Advisory Boards:

    1. NONE

    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. 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. (1) NINDS, R01NS30678, data manager, 2004-2016, (2) NINDS, R01NS036695, data manager, 2008-2013, (3) NINDS, R01NS39512, data manager, 2002-2012, (4) NINDS, U01NS069763, data manager, 2010-2016, (5) NINDS, K23NS049463, data manager, 2006-2011, (6) NINDS, U01NS69208, data manager, 2010?2014

    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

  5. Brett M. Kissela, MD, MS,
    6. Scientific Advisory Boards:

    1. NONE

    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. NONE

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. I have received compensation to perform event adjudication for clinical trials sponsored by Janssen and AbbVie.

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NIH funding for multiple grants

    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

  6. Matthew L. Flaherty, MD,
    7. Scientific Advisory Boards:

    1. Scientific advisory board, Portola Pharmaceuticals DSMB member, I-DEF Trial (NINDS sponsored ICH treatment trial)

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. US Patent 9,357,970 B2. Apparatuses and Methods for Neurological Status Evaluation Using Electromagnetics Signals. This patent is for a non-invasive CNS sensor intended to monitor intracranial hemorrhage.

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. Co-founder, SENSE Diagnostics, LLC, 2013-present

    Consultancies:

    1. Garretson Resolution Group. Consulting related to NFL Concussion Settlement.

    Speakers' Bureaus:

    1. Speakers bureaus, CSL Behring amd Janssen

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. 1. Principal Investigator of a phase II, NINDS funded trial testing recombinant activated factor VII for treatment of intracerebral hemorrahge (NINDS 2P50NS044283, Project 2). Study drug is supplied by Novo Nordisk. 2. Research support from an unrestricted educational grant from Pfizer, 2013-2015, and Bristol Myers Squibb, 2015-present

    Research Support, Government Entities:

    1. 1. NINDS 2P50NS044283, Principal Investigator, 2008- present. 2. NINDS R01 NS030678, Co-investigator, 2003-present. 3. NINDS R01 NS036695, Co-investigator, 2003-present. 4. NINDS U01 NS069763, Co-investigator, 2010-present.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. American Heart Assocation, Co-investigator, 2015-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. Own company stock as co-founder of SENSE Diagnostics, LLC, 2013-present. Our product is currently investigational and not on the market.

    Legal Proceedings:

    1. NONE

  7. Opeolu Adeoye, MD, MS,
    8. Scientific Advisory Boards:

    1. NONE

    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. 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. NIH/NINDS - 5U01NS062851-02, Site PI NIH/NINDS - 5P50NS044283-08, Co-I NIH/NINDS - 5U10NS058982-04, Co-I NIH/NIBIB - 5U54EB007954-04, Project PI

    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. Daniel Woo, MD, MS,
    9. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. (1) Stroke Research and Treatment, Associate Editor, 2010-2014.

    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. NIH Funding: NS36695 (PI: 1998-Current); NS30678 (CoI: 1998-Current). NS69763 (PI: 2010-Current).

    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

  9. Simona Ferioli, MD,
    10. Scientific Advisory Boards:

    1. NONE

    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. 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

  10. Felipe De Los Rios La Rosa, MD,
    11. Scientific Advisory Boards:

    1. 1) Scientific advisory board for Boehringer Ingelheim

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. (1) American Academy of Neurology, travel honoraria.(2) Fundaci?n Cardiovascular de Colombia, travel honoraria.

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. (1)Boehringer Ingelheim

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1) NINDS/NIH, R01 NS030678-18, training grant, 2011

    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

  11. Sharyl Martini, MD, PhD,
    12. Scientific Advisory Boards:

    1. NONE

    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. 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. NIH/ NINDS T32 NS047996 trainee, 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

  12. Pooja Khatri, MD,
    13. Scientific Advisory Boards:

    1. Biogen - DSMB

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Stroke journal editorial board J of Interventional Neurology ediitorial board

    Patents:

    1. NONE

    Publishing Royalties:

    1. UpToDate, Inc (Strokes after Cardiac Catheterization)

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Grand Rounds Experts, Inc (online clinical consultation)

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. 1. Penumbra, Inc paid Dept of Neurology for my efforts as Neurology PI of the THERAPY Trial 2. Genentech, Inc paid Dept of Neurology for my efforts as Lead PI of the PRISMS Trial

    Research Support, Government Entities:

    1. 1. NIH/NINDS U10, StrokeNET RCC Site PI 2. NIH/NINDS U01 StrokeNET NCC Co-I 3. Other NIH/NINDS subinvestigator roles

    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. Provided expert consultation to a legal firm for a stroke case

  13. Joseph P. Broderick, MD,
    14. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Travel expenses reimbursed by Universities as part as invited Visiting Professor over past 2 years - approximately 4-5 times per year.

    Editorial Boards:

    1. NONE

    Patents:

    1. Method for Controlling the Lysis of Coagulated Blood with Apolipoprotein e4 Phenotype. US Patent 7, 135, 305, issued November 15, 2006. Also, a closely related patent in 2007.

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. Pfizer 2014-2015 for work on new potential treatment for ICH. All monies paid to Department for educational/research fund.

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. Monies paid to Department of Neurology by Genentech for role on PRISMS Trial steering committee

    Research Support, Government Entities:

    1. NINDS-funded CLEARER and STOP-IT Clinical Trials) P50 NS44283, 2002 to 2016, PI for NIH funded National Coordinating Center for NIH StrokeNet 2013 to present. Co-investigator (Previous PI) of NINDS-funded Genetic and Environmental Risk Factors for Hemorrhagic Stroke NIH-NINDS R01 NS36695 1998-present, Co- investigator (Previous PI) NINDS-funded ?Comparison of Hemorrhagic and Ischemic Strokes Among Blacks and Whites

    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

  14. Mario Zuccarello, MD and
    15. Scientific Advisory Boards:

    1. NINDS funded - Antihypertensive Treatment of Cerebral Hemorrhage (ATACH II)

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. 1) Scientific, editorial board, 2012-current 2) Translational Stroke Research, ed board, 2011-current 3) Intl Journal of Vascular Medicine, ed board, 2010-current 4) Annals of Neurosurgery, ed board, 2007-current

    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. 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

  15. Dawn Kleindorfer, MD
    16. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. 1) Genentech, speaker's bureau travel, 2008-present

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. Genentech, modest level

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. R01 NS30678 Kissela and Kleindorfer (PI) 4/1/2015 ? 3/30/2020 3.60 cal mos NIH $7,578,621 Hemorrhagic and Ischemic Stroke Among Blacks and Whites (EPI) Role: Co-PI U01 NS041588 Howard (PI) ? Kissela (Site PI) 09/24/2011 ? 11/30/2017 3.00 cal mos Subaward w/Univ of Alabama Birmingham $116,286 ?Etiology of Geographic and Racial Differences in Stroke (REGARDS)? U01NS086872 (Broderick) 09/30/2013 ? 07/31/2018 2.40 cal mos NIH/NINDS $1,623,735 ?NSTN National Clinical Coordinating Center? U10 NS086512 (Khatri/Kleindorfer) 09/30/2013 ? 07/31/2018 1.80 cal mos NIH/NINDS $250,000 ?Cincinnati Regional Coordinating Stroke Center (Cincinnati RCC)?

    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 (J.M.), Indiana University School of Medicine, Indianapolis; Division of Biostatistics and Epidemiology (J.C.K.), Cincinnati Children's Hospital; Departments of Neurology (K.A., C.J.M., B.M.K., M.L.F., D.W., S.F., F.D.L.R.L.R., P.K., J.P.B., D.K.), Emergency Medicine (O.A.), and Neurosurgery (M.Z.), University of Cincinnati College of Medicine, OH; Department of Neurology (F.D.L.R.L.R.), University of New Mexico Health Sciences Center, Albuquerque; and Department of Neurology (S.M.), Baylor College of Medicine, Houston, TX.
  1. Correspondence to Dr. Mackey: jsmackey{at}iupui.edu
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