ORIGINAL CONTRIBUTION Insular Cortex Infarction in Acute Middle Cerebral Artery Territory Stroke Predictor of Stroke Severity and Vascular Lesion

Background: Insula infarction is an early computed to-mographic sign of middle cerebral artery (MCA) territory stroke andmay affect cardiovascular autonomic function. Objective: To determine insula involvement in MCA territory infarction and its relationship with infarcts in the remainder of the MCA territory, stroke severity, and clinically relevant cardiovascular conditions. Design:Case series (August 1, 1997, to June 30, 2000). Setting: Academic stroke center. Patients: A total of 150 consecutive patients with non-lacunar MCA territory stroke who underwent magnetic resonance imaging within 48 hours of stroke onset. Main Outcome Measures: Association of insula in-farctionwith theNational Institutes ofHealth Stroke Scale (NIHSS) score, location of vascular occlusion, and car