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  1. Article: Addressing the Stroke Triage Challenge.

    Advani, Rajiv

    Frontiers in neurology

    2021  Volume 12, Page(s) 670204

    Language English
    Publishing date 2021-04-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2021.670204
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Editorial: Critical Care After Stroke.

    Advani, Rajiv / Faigle, Roland / Ko, Sang-Bae

    Frontiers in neurology

    2022  Volume 13, Page(s) 903417

    Language English
    Publishing date 2022-04-13
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2022.903417
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  3. Article ; Online: Editorial

    Rajiv Advani / Roland Faigle / Sang-Bae Ko

    Frontiers in Neurology, Vol

    Critical Care After Stroke

    2022  Volume 13

    Keywords stroke ; intracerebral hemorrhage ; ischemic stroke ; acute medicine ; critical care ; thrombolysis (tPA) ; Neurology. Diseases of the nervous system ; RC346-429
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: Reversed Robin Hood syndrome visualized by CT perfusion.

    Advani, Rajiv / Sandset, Else Charlotte / Stjernstrøm, Espen

    Radiology case reports

    2021  Volume 16, Issue 4, Page(s) 884–887

    Abstract: Reversed Robin Hood Syndrome (RRHS) was first described in 2007 as a cause of worsening neurological deficit in the setting of an acute ischemic event. RRHS is the shunting of cerebral blood flow to nonstenotic vascular territories due to impaired ... ...

    Abstract Reversed Robin Hood Syndrome (RRHS) was first described in 2007 as a cause of worsening neurological deficit in the setting of an acute ischemic event. RRHS is the shunting of cerebral blood flow to nonstenotic vascular territories due to impaired vasodilation bought on by hypercapnia. A 77 year old lady presented with acute onset left hemiparesis and an exacerbation of her underlying chronic obstructive pulmonary disease (COPD). CT angiography and perfusion visualized RRHS and appropriate treatment was initiated. Treatment strategies for RRHS differ considerably to those for acute ischemic stroke. Choosing the correct treatment strategy is decisive for good clinical outcome.
    Language English
    Publishing date 2021-02-02
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2406300-9
    ISSN 1930-0433
    ISSN 1930-0433
    DOI 10.1016/j.radcr.2021.01.047
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  5. Article ; Online: Mechanical thrombectomy: Lessons to be learned from intravenous thrombolysis.

    Advani, Rajiv / Ajmi, Soffien / Kurz, Martin W

    Brain and behavior

    2019  Volume 10, Issue 1, Page(s) e01500

    Language English
    Publishing date 2019-12-13
    Publishing country United States
    Document type Editorial
    ZDB-ID 2623587-0
    ISSN 2162-3279 ; 2162-3279
    ISSN (online) 2162-3279
    ISSN 2162-3279
    DOI 10.1002/brb3.1500
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  6. Article: Multiple simultaneous embolic cerebral infarctions 11 months after COVID-19.

    Advani, Rajiv / Strømsnes, Torbjørn Austveg / Stjernstrøm, Espen / Lugg, Sebastian T

    Thrombosis journal

    2021  Volume 19, Issue 1, Page(s) 57

    Abstract: Background: The coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these may be a COVID-19 associated ... ...

    Abstract Background: The coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these may be a COVID-19 associated coagulopathy that can present as a venous thromboembolism (VTE) and further, as multiple paradoxical cerebral emboli.
    Case presentation: A 51 year old man presented to the emergency department with multiple simultaneous embolic cerebral infarctions 11 months after mild COVID-19. In the subacute phase of the COVID-19 illness the patient developed increasing shortness of breath and was found to have an elevated D-dimer and multiple bilateral segmental pulmonary emboli. He was subsequently treated with 3 months of anticoagulation for a provoked VTE. The patient then presented 11 months after the initial COVID-19 diagnosis with multiple simultaneous cerebral infarctions where no traditional underlying stroke etiology was determined. A patent foramen ovale (PFO) and an elevated D-dimer were found suggesting a paradoxical thromboembolic event due to an underlying coagulopathy.
    Conclusions: This case report highlights the one of the potentially more serious complications of long-term COVID-19 where VTE due to a persistent coagulopathy is seen almost a year after the initial illness. Due to the highly prevalent nature of PFO in the general population, VTE due to COVID-19 associated coagulopathy could lead to ischemic stroke. This case report highlights the possibility for an underlying COVID-19 associated coagulopathy which may persist for many months and beyond the initial illness.
    Language English
    Publishing date 2021-08-18
    Publishing country England
    Document type Journal Article
    ISSN 1477-9560
    ISSN 1477-9560
    DOI 10.1186/s12959-021-00304-8
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  7. Article ; Online: Iatrogenic stroke caused by cerebral air embolism and acute reperfusion therapy using hyperbaric oxygen.

    Strømsnes, Torbjørn Austveg / Røed, Ine / Strøm, Hanna / Advani, Rajiv / Biernat, Donata / Ihle-Hansen, Hege

    BJR case reports

    2022  Volume 8, Issue 3, Page(s) 20210201

    Abstract: Objective: Air embolisms are mostly iatrogenic and a rare yet dreaded complication following percutaneous procedures. Intravascular entrapment of air can result in occlusion of end arteries and subsequent tissue ischemia and infarction. Cerebrovascular ... ...

    Abstract Objective: Air embolisms are mostly iatrogenic and a rare yet dreaded complication following percutaneous procedures. Intravascular entrapment of air can result in occlusion of end arteries and subsequent tissue ischemia and infarction. Cerebrovascular occlusions caused by air embolisms are time-sensitive and an uncommon cause of ischemic stroke, warranting an alternative acute management and reperfusion strategy.
    Methods: During a CT-guided lung biopsy, the patient developed left-sided paresis and sensory deficits prior to loss of consciousness. CT revealed air in the aorta, both ophthalmic arteries and vessels in the right parietal region. The patient was swiftly air-lifted to the nearest hyperbaric oxygen chamber for an alternate emergency reperfusion therapy. The following eight days the patient received hyperbaric oxygen therapy and gradually improved. Nine days after symptom onset he was discharged with a minor left facial palsy.
    Conclusions: Cerebrovascular occlusions are critical events regardless of etiology. Air embolism is rare but potentially catastrophic and can occur during both percutaneous procedures and surgeries. Vigilance and knowledge of this potential complication are needed to rapidly provide beneficial treatment. That is, high flow oxygen and correct positioning pending hyperbaric oxygen therapy.
    Language English
    Publishing date 2022-02-04
    Publishing country England
    Document type Case Reports
    ISSN 2055-7159
    ISSN (online) 2055-7159
    DOI 10.1259/bjrcr.20210201
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  8. Article ; Online: The Endothelial Barrier Is not Rate-limiting to Insulin Action in the Myocardium of Male Mice.

    Sanwal, Rajiv / Khosraviani, Negar / Advani, Suzanne L / Advani, Andrew / Lee, Warren L

    Endocrinology

    2020  Volume 161, Issue 4

    Abstract: To act on tissues, circulating insulin must perfuse the relevant organ and then leave the bloodstream by crossing the endothelium-a process known as insulin delivery. It has been postulated that the continuous endothelium is a rate-limiting barrier to ... ...

    Abstract To act on tissues, circulating insulin must perfuse the relevant organ and then leave the bloodstream by crossing the endothelium-a process known as insulin delivery. It has been postulated that the continuous endothelium is a rate-limiting barrier to insulin delivery but existing data are contradictory. This conflict is in part due to the limitations of current models, including the inability to maintain a constant blood pressure in animals and the absence of shear stress in cultured cells. We developed a murine cardiac ex vivo perfusion model that delivers insulin to the heart in situ at a constant flow. We hypothesized that if the endothelial barrier were rate-limiting to insulin delivery, increasing endothelial permeability would accelerate insulin action. The kinetics of myocardial insulin action were determined in the presence or absence of agents that increased endothelial permeability. Permeability was measured using Evans Blue, which binds with high affinity to albumin. During our experiments, the myocardium remained sensitive to insulin and the vasculature retained barrier integrity. Perfusion with insulin induced Akt phosphorylation in myocytes but not in the endothelium. Infusion of platelet-activating factor or vascular endothelial growth factor significantly increased permeability to albumin without altering insulin action. Amiloride, an inhibitor of fluid-phase uptake, also did not alter insulin action. These data suggest that the endothelial barrier is not rate limiting to insulin's action in the heart; its passage out of the coronary circulation is consistent with diffusion or convection. Modulation of transendothelial transport to overcome insulin resistance is unlikely to be a viable therapeutic strategy.
    MeSH term(s) Animals ; Capillary Permeability/drug effects ; Cell Line ; Endothelial Cells/metabolism ; Endothelium, Vascular/drug effects ; Endothelium, Vascular/metabolism ; Heart/drug effects ; Humans ; Insulin/pharmacology ; Male ; Mice ; Myocardium/metabolism ; Phosphorylation/drug effects ; Platelet Activating Factor/pharmacology ; Proto-Oncogene Proteins c-akt/metabolism ; Signal Transduction/drug effects
    Chemical Substances Insulin ; Platelet Activating Factor ; Proto-Oncogene Proteins c-akt (EC 2.7.11.1)
    Language English
    Publishing date 2020-02-27
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 427856-2
    ISSN 1945-7170 ; 0013-7227
    ISSN (online) 1945-7170
    ISSN 0013-7227
    DOI 10.1210/endocr/bqaa029
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    Uh III Zs.72: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Thrombectomy in large vessel occlusion stroke-Does age matter?

    Rezai, Mehdi K / Dalen, Ingvild / Advani, Rajiv / Fjetland, Lars / Kurz, Kathinka D / Sandve, Knut Olav / Kurz, Martin W

    Acta neurologica Scandinavica

    2022  Volume 146, Issue 5, Page(s) 628–634

    Abstract: Objectives: Endovascular treatment (EVT) is the gold standard treatment for emergent large vessel occlusion (LVO). The benefit of EVT for emergent LVO in elderly patients (>80 years old) is still debated as they have been under-represented in randomized ...

    Abstract Objectives: Endovascular treatment (EVT) is the gold standard treatment for emergent large vessel occlusion (LVO). The benefit of EVT for emergent LVO in elderly patients (>80 years old) is still debated as they have been under-represented in randomized controlled trials. Elderly patients with an emergent LVO are a growing population warranting further study.
    Materials & methods: We included 225 consecutive patients treated with EVT for LVO either in the anterior or posterior circulation. The clinical outcome was assessed using the National Institute of Health Stroke Scale (NIHSS). Long-term functional outcome was assessed using 90-day modified ranking scale (mRS).
    Results: Neurological improvement: A five-year higher age predicted a 0.43 higher mean NIHSS score after EVT (p = .027). After adjusting for confounders (influencing variables), the association between age and post-interventional NIHSS was reduced and non-significant (p = .17). At discharge, a five-year higher age predicted a 0.74 higher mean NIHSS (p = .003). After adjusting for confounders this association was reduced and non-significant (p = .06). Long-term functional outcome: A five-year higher age predicted a 0.20 higher mRS at three months (p < .001). When adjusting for confounders this number was reduced to 0.16, yet still highly significant (p < .001).
    Conclusions: Age seems to have a minor role in predicting neurological improvement after EVT but has an impact on long-term functional outcome. The decision to perform or withhold EVT should therefore not solely be based on age.
    MeSH term(s) Aged, 80 and over ; Brain Ischemia/epidemiology ; Endovascular Procedures ; Humans ; Ischemic Stroke ; Retrospective Studies ; Stroke/epidemiology ; Thrombectomy/adverse effects ; Treatment Outcome
    Language English
    Publishing date 2022-08-27
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 90-5
    ISSN 1600-0404 ; 0001-6314
    ISSN (online) 1600-0404
    ISSN 0001-6314
    DOI 10.1111/ane.13691
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    In stock of ZB MED Cologne/Königswinter

    Ui I Zs.142: Show issues Location:
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  10. Article ; Online: Reversed Robin Hood syndrome visualized by CT perfusion

    Rajiv Advani, MD, PhD / Else Charlotte Sandset, MD, PhD / Espen Stjernstrøm, MD

    Radiology Case Reports, Vol 16, Iss 4, Pp 884-

    2021  Volume 887

    Abstract: Reversed Robin Hood Syndrome (RRHS) was first described in 2007 as a cause of worsening neurological deficit in the setting of an acute ischemic event. RRHS is the shunting of cerebral blood flow to nonstenotic vascular territories due to impaired ... ...

    Abstract Reversed Robin Hood Syndrome (RRHS) was first described in 2007 as a cause of worsening neurological deficit in the setting of an acute ischemic event. RRHS is the shunting of cerebral blood flow to nonstenotic vascular territories due to impaired vasodilation bought on by hypercapnia. A 77 year old lady presented with acute onset left hemiparesis and an exacerbation of her underlying chronic obstructive pulmonary disease (COPD). CT angiography and perfusion visualized RRHS and appropriate treatment was initiated. Treatment strategies for RRHS differ considerably to those for acute ischemic stroke. Choosing the correct treatment strategy is decisive for good clinical outcome.
    Keywords Stroke ; CT ; angiography ; MRI ; DWI ; Carotid artery stenosis ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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