Abstract: Objective To investigate the symptoms, signs and distribution of focus in acute insular infarct syndrome, as well as the effects on cardiovascular system. Methods The clinical manifestations of 20 patients with first-event acute insular infarct syndrome were analyzed retrospectively. Results All the patients revealed the intellectual deterioration, aphasia, hemiparalysis, sensory disorder and vestibular-like symptoms. The temporal lobes were mostly involved (65%). Electrocardiogram showed ST segment depressed mostly. The supraventricular premature beats were the most frequence finding by Holter monitoring in left insular infarction except atrial fibrillation, and their heart rate variability indicated that the standard deviation of normal-to-normal intervals (SDNN) decreased, but root mean square successive difference (RMSSD) increased. Conclusion The insular infarct syndrome can be charactered as a group of symptoms of intellectual deterioration, aphasia, hemiparalysis, sensory disorder and vestibular-like symptom. Left insular infarct could be complicated with arrhythmia, which increases the risk of adverse cardiac outcome. The characteristics of arteries to Sylvian angle may be associated with the syndrome.

Key words: insula, cerebral infarction, insular infarct syndrome, clinical features, neurological, cardiovascular, heart rate variability