An isolated insular infarct is a form of insular infarct where the infarct is confined to the insular cortex or region supplied by the long insular artery. Infarcts in insula can additionally by supplied by the MCA branches as well as the lenticulostriate branches.
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Clinical presentation
An isolated insular infarct may manifest with a combination of deficits which can include 3,4
- somatosensory deficits
- gustatory/speaking deficits
- coordination issues/vestibular-like syndrome with
- “vestibular-like syndrome” has been reported in around a third of patients 6
- dizziness, gait instability, and tendency to fall, but no nystagmus
- cardiovascular/autonomic disturbances - hypertensive episodes
- neuropsychological/cognitive disorders
- aphasia (left posterior insula)
- dysarthria
- transient somatoparaphrenia (right posterior insula)
Associations
- there can be a high frequency detection of cardiac disturbances (e.g. atrial fibrillation) 3
Pathology
Etiology
The etiology can vary from being cardioembolic to large artery disease to cryptogenic 6.
Treatment and prognosis
Isolated insular infarcts have a generally better overall long term outcome compared to a large territory stroke 6.