Insular stroke is associated with acute sympathetic hyperactivation and immunodepression

• DOI: 10.1111/j.1468-1331.2012.03818.x
• Publication Date: 2012-07-27T20:01:10Z
• Authors: U. Walter; S. Kolbaske; R. Patejdl; V. Steinhagen; M. Abu‐Mugheisib; A. Grossmann; C. Zingler; R. Benecke
• Keywords: Stroke; Pathogenesis

Background and purpose Post‐stroke immunodepression has been related to brain lesion size but not a specific location. Here, we studied the influence of location within middle cerebral artery ( MCA ) territory on parameters activation sympathetic adrenomedullar pathway, immunodepression, associated infection. Methods We analyzed clinical, imaging, laboratory data 384 patients (174 women; mean age 70.8 ± 12.9 years) consecutively admitted stroke unit no later than 24 h after onset acute ischaemic involving territory. Results Patients with affecting >33% had increased serum metanephrine normetanephrine levels, elevated neutrophil counts decreased eosinophil, helper T lymphocyte, cytotoxic lymphocyte compared in <33% large infarctions frequency infections 14 days stroke, especially chest P < 0.001). Considering only non‐lacunar infarction territory, those insular significantly higher lower eosinophil non‐insular lesion, despite similar diameters. This coincided an 0.01) lesion. Whilst right showed heart rate variability, laterality impact findings or infection frequency. Conclusion These suggest role pathogenesis stroke‐induced hyperactivation immunodepression. Neuroimaging studies applying volume calculation techniques are warranted confirm these findings.