MIDDLE CEREBRAL ARTERY
The Middle Cerebral Artery (MCA) is the most common site of stroke.
MCA infarcts occur in 2 general regions: Superficial Divisions & Lenticulostriate Branches
Structures supplied by the MCA:
- Left Superficial Division
- Right Superficial Division
- Lenticulostriate Branches
- Clinical Syndromes of MCA Territories
BROCA'S AREA
Expressive speech area.
Integration with other language areas.
Integration with other language areas.
WERNICKE'S AREA
Receptive speech area.
Integration with other language areas.
Integration with other language areas.
MOTOR CORTEX
Movement of right head and neck,
movement of right arm.
movement of right arm.
SENSORY CORTEX
Sensation from right head and neck,
sensation from right arm.
sensation from right arm.
MOTOR CORTEX
Movement of left head and neck,
movement of left arm.
movement of left arm.
SENSORY CORTEX
Sensation from left head and neck,
sensation from left arm.
sensation from left arm.
STRIATUM (Caudate and Putamen)
Receives cortical inputs to basal ganglia.
Functions in the direct and indirect pathways for the initiation and control of movement.
Functions in the direct and indirect pathways for the initiation and control of movement.
GLOBUS PALLIDUS
Site of origin of output from the basal ganglia to substantia nigra and thalamus. Functions in the direct and indirect pathways for the initiation and control of movement.
INTERNAL CAPSULE (Anterior Limb)
Contains corticopontine and thalamocortical fibers.
INTERNAL CAPSULE (Genu)
Contains descending fibers of the corticobulbar tract.
LOCATION OF INFARCT
Left MCA Superficial DivisionRight MCA Superficial Division
Left MCA Lenticulostriate Branches
Right MCA Lenticulostriate Branches
DEFICITS
Right face and arm upper-motor weakness due to damage to motor cortex, nonfluent (Broca’s) aphasia due to damage to Broca’s area. There may also be right face and arm cortical type sensory loss if the infarct involves the sensory cortex. Other deficits include a fluent (Wernicke’s) aphasia due to damage to Wernicke’s area.Left face and arm upper-motor weakness due to damage to motor cortex. Left hemineglect (variable) due to damage to non-dominant association areas. There may also be left face and arm cortical type sensory loss if the infarct involves the sensory cortex.
Right pure upper-motor hemiparesis due to damage to the basal ganglia (globus pallidus and striatum) and the genu of the internal capsule on the left side. Larger infarcts extending to the cortex may produce cortical deficits such as aphasia.
Left pure upper-motor hemiparesis due to damage to the basal ganglia (globus pallidus and striatum) and the genu of the internal capsule on the right side. Larger infarcts extending to the cortex may produce cortical deficits such as aphasia.





