[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Insula [Nervous system](https://durgical.com/en/anatomy/system/nervous-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Insula The insula is a lobe of the brain hidden deep in the lateral groove; it handles taste, gut feelings, pain and awareness of the body's inner state. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=insula&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A lobe hidden deep in the lateral sulcus. ## What it does Taste, gut feelings, pain and awareness of the body's inner state. ## Key points - Hidden in the lateral sulcus under the frontal, parietal and temporal opercula and outlined by the circular sulcus; the central insular sulcus separates short anterior from long posterior gyri - Loss of the insular ribbon (the grey–white boundary of the insula) on CT is one of the earliest signs of a middle cerebral artery stroke - Primary taste cortex (with the frontal operculum), visceral sensation and interoception; the anterior insula is linked to disgust, craving and awareness of the body's inner state ## Key facts **Where** Deep in the lateral sulcus **Blood supply** MCA (M2 insular branches) **Function** Taste, visceral sensation, interoception ## Relations **Lateral** Frontal, parietal and temporal opercula; the M2 branches of the [middle cerebral artery](https://durgical.com/en/anatomy/middle-cerebral-artery/) run over its surface inside the [lateral sulcus](https://durgical.com/en/anatomy/lateral-sulcus/) **Below** Limen insulae at its front lower pole, where the middle cerebral artery bends from its M1 into its M2 segment **Deep** From lateral to medial: extreme capsule, claustrum, external capsule, then the [putamen](https://durgical.com/en/anatomy/putamen/) ## How to find it It cannot be seen on the intact brain surface; it is exposed by opening the lateral sulcus (transsylvian approach) or by removing the opercula. On axial and coronal MRI it is the cortex at the deep floor of the Sylvian fissure, just lateral to the putamen, with the M2 branches running in the fissure over it. ## On imaging Insular ribbon sign on non-contrast CT within hours of a middle cerebral artery occlusion, often with a hyperdense artery sign. The insula is also a frequent site of diffuse low-grade gliomas, seen as a bright, expanded insula on T2/FLAIR. ## Clinical notes - Insular strokes, especially on the right, have been linked to heart rhythm disturbances and blood pressure swings (some texts) - Insular seizures can mimic other events: throat tightness or choking, [chest](https://durgical.com/en/anatomy/region/chest/) or epigastric discomfort, taste changes or drooling - Surgery for insular tumours goes through the Sylvian fissure; the long perforating branches of M2 that feed the corona radiata must be spared to avoid weakness ## Development It grows more slowly than the surrounding cortex, which folds over it as the opercula during fetal life; the opercula close around term, so in very preterm infants the insula is still uncovered. ## Memory aid Insula means island: the cortex left behind, like an island, as the lobes around it grew over it (island of Reil). ## Related conditions - [Panic disorder](https://durgical.com/en/conditions/panic-disorder/) - [Social anxiety disorder and specific phobia](https://durgical.com/en/conditions/social-anxiety-disorder-and-specific-phobia/) - [Somatic symptom and illness anxiety disorders](https://durgical.com/en/conditions/somatic-symptom-and-illness-anxiety-disorders/) ## Test yourself Think of the answer, then tap the question to see it. ## Where is the insula? Deep in the lateral sulcus, hidden under the frontal, parietal and temporal opercula and outlined by the circular sulcus. ## What is the insular ribbon sign on CT? Loss of the grey–white boundary of the insula, one of the earliest signs of a middle cerebral artery stroke. ## What structures lie deep to the insula, from lateral to medial? Extreme capsule, claustrum, external capsule, then the putamen. ## Which functions are linked to the insula? Primary taste cortex (with the frontal operculum), visceral sensation and interoception, the awareness of the body's inner state. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/insula/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** insula TA2 5502 **Official Spanish (DeCS)** Corteza Insular DeCS D000087623 **English (TA2)** Insula **Also called** insular cortex · island of Reil · insular lobe · insula of Reil ## Related - [Middle cerebral artery](https://durgical.com/en/anatomy/middle-cerebral-artery/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=59651&filter=ths_termall&q=Insular%20Cortex); [Insular Cortex](https://www.ncbi.nlm.nih.gov/books/NBK570606/); [Neuroanatomy, Sylvian Fissure](https://www.ncbi.nlm.nih.gov/books/NBK574552/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/insula/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/insula/