Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Postgrad Med J. 2019 Sep;95(1127):497-504. doi: 10.1136/postgradmedj-2019-136732. Epub 2019 Jul 11.
Infarction of the insula is a common scenario with large tissue-volume strokes in the middle cerebral artery territory. Considered to be part of the central autonomic network, infarction of this region is associated with autonomic disturbances, in particular cardiovascular dysregulation. Risk of aspiration following stroke is also associated with involvement of the insula, consistent with its purported participation in complex functions of the mouth and pharynx. Strokes restricted to the insula are rare and present with a broad range of symptoms that offer a window of insight into the diverse functionality of the insular cortex. Chemosensory, autonomic, vestibular, auditory, somatosensory, language and oropharyngeal functional deficits are all recognised, among others. Long-term sequelae are unknown but profound symptoms, such as hemiparesis, are usually transient. Understanding the patterns of dysfunction highlighted provides the basis for future strategies to optimise stroke management on the discovery of insula involvement.
脑岛梗死是大脑中动脉区域大体积卒中的常见情况。脑岛被认为是自主神经系统的一部分，该区域的梗死与自主功能障碍有关，特别是心血管调节障碍。卒中后发生吸入的风险也与脑岛的受累有关，这与它在口腔和咽部的复杂功能中的作用一致。局限于脑岛的卒中很少见，表现出广泛的症状，为了解脑岛皮质的多种功能提供了一个窗口。除其他外，还认识到化学感觉、自主、前庭、听觉、躯体感觉、语言和口咽功能缺陷。长期后遗症尚不清楚，但严重的症状，如偏瘫，通常是短暂的。了解突出的功能障碍模式为未来的策略提供了基础，以优化发现脑岛受累后的卒中管理。
