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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Insular ischemic stroke: clinical presentation and outcome.
F Lemieux1, S Lanthier, M-C Chevrier
1Service de Neurologie, Hôpital Notre-Dame, Centre Hospitalier de l'Université de Montréal, Montréal, Qué., Canada.
Cerebrovascular Diseases Extra
|November 10, 2012
Summary
Insular ischemic strokes (IIS) present with varied symptoms, often combining motor, sensory, and speech deficits. Most patients experience favorable outcomes, but further research is needed.
Area of Science:
- Neurology
- Neuroscience
- Stroke Medicine
Background:
- The insula, a deep cerebral structure, is rarely affected by isolated ischemic strokes.
- Insular ischemic strokes (IIS) are not well-characterized.
- This study aims to define the clinical presentation and outcomes of IIS.
Purpose of the Study:
- To characterize the clinical presentation of insular ischemic strokes (IIS).
- To determine the outcomes of patients with IIS.
- To correlate clinicoradiological findings with specific insular involvement (anterior vs. posterior).
Main Methods:
- Retrospective review of a two-center stroke database (2008-2010).
- Medline search for published cases of insular infarction confirmed by MRI.
- Clinicoradiological correlation, differentiating anterior (AIC) and posterior insular cortex (PIC) involvement.
Main Results:
- A total of 23 IIS cases were analyzed (7 institutional, 16 published).
- Infarcts involved AIC (n=4), PIC (n=12), or both (n=7).
- Common symptoms included somatosensory deficits, aphasia, dysarthria, vestibular-like syndrome, and motor deficits; PIC involvement correlated with somatosensory deficits (p=0.04).
Conclusions:
- Insular ischemic strokes (IIS) exhibit variable presentations with multimodal deficits due to the insula's complex functions.
- Suspicion for IIS is warranted when vestibular, motor, somatosensory, speech, or language disturbances co-occur.
- The outcome for IIS is frequently favorable, though larger studies are necessary.
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