Preferred involvement of the basal ganglia after lenticulostriate infarction as a possible indicator of different gray and white matter vulnerability.

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.