Cereda C, Ghika J, Maeder P, Bogousslavsky J
Department of Neurology, CHUV, Lausanne, Switzerland.
Neurology. 2002 Dec 24;59(12):1950-5. doi: 10.1212/01.wnl.0000038905.75660.bd.
To characterize clinically acute insular strokes from four patients with a first ever acute stroke restricted to the insula on MRI.
The authors studied the clinical presentation of four patients with a first ever acute stroke restricted to the insula on MRI.
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 (right posterior insula).
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), somatoparaphrenia (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.
通过对4例首次发生的急性脑岛卒中患者进行MRI检查，以明确其临床特征。
作者研究了4例首次发生的急性脑岛卒中患者的临床表现。
作者发现了5组主要临床表现：1）3例脑岛后部卒中患者出现躯体感觉障碍（2例为短暂性假丘脑感觉综合征，1例为部分性分布）；2）1例左侧脑岛后部梗死患者出现味觉障碍；3）3例脑岛后部卒中患者出现类似前庭综合征，表现为头晕、步态不稳和跌倒倾向，但无眼球震颤；4）心血管紊乱，包括1例右侧脑岛后部梗死患者出现高血压发作；5）神经心理障碍，包括失语（左侧脑岛后部）、构音障碍和短暂性躯体失认症（右侧脑岛后部）。
局限于脑岛后部的卒中可能以假丘脑感觉和类似前庭综合征为突出临床表现，但也可能出现构音障碍和失语（左侧病变）、躯体失认症（右侧病变）以及味觉功能障碍和右侧病变伴高血压发作的血压异常；我们未发现脑岛前部卒中患者有急性吞咽困难的报道。
