Strokes restricted to the insular cortex
Strokes restricted to the insular cortex
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DOI：
10.1212/01.wnl.0000038905.75660.bd
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发表时间：
2002-12-24
期刊：
影响因子：
9.9
通讯作者：
Bogousslavsky, J
中科院分区：
文献类型：
--
作者：
Cereda, C;Ghika, J;Bogousslavsky, J
目的：对4例首次急性岛叶卒中患者的MRI表现进行分析，探讨其临床特点。方法：作者研究了4例首次发生于脑岛的急性卒中患者的临床表现。结果：作者发现了五组主要的临床表现：1)3例后岛叶卒中患者的躯体感觉障碍(2例为暂时性假丘脑感觉综合征，1例为部分分布)；2)左侧后岛叶梗死患者的味觉障碍；3)3例后岛叶卒中患者的前庭样综合征，伴有头晕、步态不稳和倾向于摔倒，但没有眼震；4)心血管障碍，包括右后岛梗死患者的高血压发作；5)神经心理障碍，包括失语(左侧后岛)、构音障碍和一过性躯体失语(轻度后岛)。结论：局限于后岛叶的卒中可表现为伪丘脑感觉和前庭样征，但也可伴有构音障碍和失语(左侧病变)、呼吸紊乱。(右侧病变)和右侧病变中伴有高血压发作的味觉功能障碍和血压；我们没有发现急性吞咽困难发生在前部、岛叶卒中的报道。
Objective: To characterize clinically acute insular strokes from four patients with a first ever acute stroke restricted to the insula on MRI. Methods: The authors studied the clinical presentation of four patients with a first ever acute stroke restricted to the insula on MRI. Results: The authors found five main groups of clinical presentations: 1) somatosensory deficits in three patients with posterior insular stroke (two with a transient pseudothalamic sensory syndrome, one with partial distribution); 2) gustatory disorder in a patient with left posterior insular infarct; 3) vestibular-like syndrome, with dizziness, gait instability, and tendency to fall, but no nystagmus, in three patients with posterior insular strokes; 4) cardiovascular disturbances, consisting of hypertensive episodes in a patient with a right posterior insular infarct; and 5) neuropsychological disorders, including aphasia (left posterior insula), dysarthria, and transient somatoparaphrenia (light posterior insula). Conclusion: Strokes restricted to the posterior insula may, present with pseudothalamic sensory and vestibular-like syndromes as prominent clinical manifestations, but also dysarthria and aphasia (in left lesions), sornatoparaphrenia. (right lesions) and gustatory dysfunction and blood pressure with hypertensive episodes in right lesions; we did not find acute dysphagia reported in anterior, insular strokes.