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Published Online
on January 3, 2008

Stroke. 2008
Published online before print January 3, 2008, doi: 10.1161/STROKEAHA.107.484337
A more recent version of this article appeared on February 1, 2008
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Submitted on February 5, 2007
Revised on May 8, 2007
Accepted on June 7, 2007

Preferred Involvement of the Basal Ganglia After Lenticulostriate Infarction as a Possible Indicator of Different Gray and White Matter Vulnerability

Yoshinari Nagakane MD, PhD*; Kei Yamada MD, PhD; Tomoyuki Ohara MD; Kenji Yoshikawa MD, PhD; Nagato Kuriyama MD, PhD; Natsuko Takayasu MD; Takashi Kasai MD; Natsuko Yuki MD; Tsunehiko Nishimura MD, PhD; Toshiki Mizuno MD, PhD; and Masanori Nakagawa MD, PhD

From the Departments of Neurology (Y.N., T.O., K. Yoshikawa, N.K., N.T., T.K., N.Y., T.M., M.N.) and Radiology (K. Yamada, T.N.), Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

* To whom correspondence should be addressed. E-mail: nagakane{at}koto.kpu-m.ac.jp.

Background and Purpose—Symptomatic progression is frequently observed in lacunar infarcts. The exact mechanisms of this phenomenon have not yet been clarified.

Summary of Cases—We report 2 patients with lenticulostriate artery infarcts that presented with skip lesions that were restricted to gray matter. One of the patients subsequently developed symptomatic deterioration; the other experienced no further neurological events.

Conclusions—A possible mechanism of differential vulnerability to ischemia of gray and white matter is considered. White matter may have a longer therapeutic time window for neuroprotective treatment than gray matter.
Key words: cerebral ischemia • lacunar infarction • MRI • white matter






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