Insular cortical ischaemia does not independently predict acute hypertension or hyperglycaemia within 3 h of onset.
OBJECTIVE
To test the hypothesis that insular cortical ischaemia is associated with acute hypertension and hyperglycaemia.


METHODS
From the Canadian Activase for Stroke Effectiveness Study, which included only patients treated with thrombolysis hyperacutely (ie, within 3 h of onset of stroke), 966 patients were identified with ischaemia affecting (n = 685), or sparing (n = 281), the insular cortex. Demographic and clinical data, pretreatment indices of blood pressure, blood glucose, atrial fibrillation, and clinical imaging and outcome measures were compared between the two groups. Multivariable linear regression was used to assess predictors of systolic blood pressure and glucose levels before thrombolysis.


RESULTS
Pretreatment hypertension (p = 0.009), but not hyperglycaemia (p = 0.32), was predicted by insular ischaemia in univariable linear regression analyses. After adjusting for other factors, however, insular cortical ischaemia was not found to be an independent predictor for acute hypertension or hyperglycaemia.


CONCLUSIONS
Raised blood pressure or serum glucose levels in hyperacute (<3 h) cerebral ischaemia is not independently predicted by insular involvement. Several hours are required for sympathetic manifestations of insular ischaemia to evolve.
Pettersen
J A
JA
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Pexman
J H W
JH
Barber
P A
PA
Demchuk
A M
AM
Buchan
A M
AM
Hill
M D
MD
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose; D002545:Brain Ischemia / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D006973:Hypertension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D001786:Blood Glucose