Right insular cortex infarct

Case contributed by Stefan Tigges
Diagnosis certain


Sudden onset left-sided weakness.

Patient Data

Age: 60 years.
Gender: Female

Loss of the right insular ribbon, no intracranial hemorrhage.

Case Discussion

The insular cortex, supplied by the middle cerebral artery, is at especially high risk for infarction because of poor collateral flow from the anterior and posterior cerebral arteries. Loss of the insular gray-white interface is a sign of infarction and is known as the "loss of the insular ribbon sign".

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