Head CT > Stroke > Insular Ribbon Sign

Insular Ribbon Sign

The insular ribbon sign is the loss of the gray-white interface in the lateral margins of the insula. This area is supplied by the insular segment of the middle cerebral artery and is particularly susceptible to ischemia because it is the most distal region from either anterior or posterior collaterals. The insular ribbon sign may involve only the anterior or the posterior insula.

The cortex of the left insular ribbon is not visualized (arrow).

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