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Updated: Sep 25, 2025

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Concomitant Sympathetic and Parasympathetic Dysfunction after Acute Ischemic Stroke.

Ting-Yu Chang1, Pin-Shiuan Chen2, Shin-Joe Yeh2

  • 1Department of School of Medicine, National Taiwan University, Taipei, Taiwan.

Acta Neurologica Taiwanica
|April 26, 2022
PubMed
Summary
This summary is machine-generated.

Acute ischemic stroke in the left hemisphere can cause both sympathetic and parasympathetic autonomic dysfunction. This case report details the concurrent symptoms and their sequential resolution in a stroke patient.

Keywords:
acute ischemic strokeautonomic dysfunctioninsula parietal lobe.unilateral hemisphere

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Area of Science:

  • Neurology
  • Autonomic Neuroscience
  • Stroke Medicine

Background:

  • Autonomic dysfunction is an underrecognized complication of acute ischemic stroke.
  • Cortical sympathetic regulation is predominantly right-hemisphere lateralized, while parasympathetic regulation is left-hemisphere lateralized.
  • Limited evidence exists on unilateral hemispheric lesions causing concurrent sympathetic and parasympathetic dysfunction.

Observation:

  • A 73-year-old woman experienced an acute ischemic stroke in the left middle cerebral artery territory.
  • Residual infarctions involved the left insula and lateral parietal cortex.
  • The patient presented with orthostatic hypotension (sympathetic dysfunction) and micturition difficulty with reflex tachycardia (parasympathetic dysfunction).

Findings:

  • The patient exhibited concurrent sympathetic and parasympathetic dysfunction following a left hemisphere ischemic stroke.
  • Sympathetic function resolved by day 10 post-stroke.
  • Parasympathetic function resolved by day 20 post-stroke.

Implications:

  • This case provides insight into the clinical presentation and recovery patterns of combined autonomic dysfunction after left hemispheric stroke.
  • Highlights the complex interplay between specific brain regions and autonomic nervous system regulation.
  • Underscores the importance of recognizing and managing autonomic complications in stroke patients.