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Middle Cerebral Artery (MCA) Stroke
Middle Cerebral Artery (MCA)
The MCA is supplied by the ICA. It supplies the lateral two thirds of the cerebrum.
Clinical Findings in Middle Cerebral Artery Stroke
These clinical manifestations are typically pronounced due to the extensive territory the MCA supplies, encompassing large portions of the frontal, temporal, and parietal lobes, which include key areas for motor functions, sensory processing, and higher cognitive functions.
- Contralateral Hemiparesis and Hemisensory Loss:
- Predominantly affects the face and arm more than the leg.
- Due to the MCA's supply to the primary motor and sensory cortices involved with these regions.
- Homonymous Hemianopia:
- Loss of vision in the same half of the visual field in each eye.
- Results from damage to the optic radiation in the temporal or parietal lobe.
- Aphasia:
- If the stroke occurs in the dominant hemisphere (usually the left), it can lead to: expressive (Broca's), receptive (Wernicke's), or global aphasia, depending on the specific areas affected.
- Dysarthria:
- Motor speech disorder resulting from neurological injury of the motor component of the motor-speech system.
- Spatial Neglect (if the non-dominant, typically right hemisphere is affected):
- Inattention to and lack of awareness of one side of space, usually the left.
- Apraxia:
- Difficulty in executing learned purposeful movements, not explained by sensory or motor impairment.
- Cognitive Dysfunction:
- Impairment in cognitive functions such as attention, memory, and executive functions depending on the extent and location of the infarct.
Summary of Potential Findings
- Aphasia
- Hemiplegia/Hemiparesis (Face, Arm > Leg)
- Hemianopia
- Hemianesthesia
- Hemineglect
- Circumducting Gait