Insular stroke is associated with acute sympathetic hyperactivation and immunodepression

384 patients (174 women; mean age 70.8 ± 12.9 years) consecutively admitted to the stroke unit no later than 24 h after onset of acute ischaemic stroke involving the middle cerebral artery (MCA) territory.

Acute ischemic stroke with insular lesion (within the subgroup of non-lacunar infarction in <33% of MCA territory) or large infarction (>33% of MCA territory).

Acute ischemic stroke with non-insular lesion (within the subgroup of non-lacunar infarction in <33% of MCA territory) or smaller infarction (<33% of MCA territory).

Parameters related to activation of sympathetic adrenomedullar pathway (serum metanephrine and normetanephrine levels), immunodepression (neutrophil, eosinophil, helper T lymphocyte, and cytotoxic T lymphocyte counts), and frequency of infections within 14 days after stroke.