The significance of basal ganglia infarction.

The striatum is a selectively vulnerable region of brain in animal models of ischemic stroke. We performed cerebral blood flow with single-photon emission computed tomography (SPECT) on six patients with focal basal ganglia infarction and five patients with hemispheric infarction to determine whether the striatum is selectively vulnerable to ischemia in human stroke. SPECT was performed with a Toshiba model 602A digital scintillation camera using 30 mCi (99m)Tc Ceretec. One hour after injection, scans were performed at 5° intervals to a complete 360° over 40 min. Data were processed into sagittal, axial, and coronal views. Groups were compared by Fischer's exact test. Five of the six patients with basal ganglia infarction had diffuse hemispheric ischemia. All five patients with focal hemispheric infarction had ischemia confined to that region (p = 0.01). Focal infarction of the striatum occurs in diffuse cerebral ischemia because the striatum is a selectively vulnerable brain region.