 60year-old right handed WM with
h/o HTN (hypertension), recent MI
(myocardial infarction)who had
sudden-onset Broca’s aphasia
(mute), right central facial
paralysis, right pronator drift

Left Middle Cerebral Artery
Branch Infarct (Stroke)
(Note: Not the entire territory of MCA
Is involved; the stroke is pie-shaped
and involves both gray & white matter)
Probable etiology: with the history of MI,
cardioembolic.

More clearly defined infarct,
frontal lobe

 70 year-old right handed WF, smoker, has
h/o HTN, DM (diabetes mellitus), non-
compliant with meds.
 PE: left carotid bruit; edema on right arm
 NE: awake, alert, with global
aphasia, left gaze deviation, no response
to visual threat presented on right visual
field; right hemiparesis (RUE plegic, RLE
3/5 long-tract pattern of
weakness), impaired sensation on the
right side

 70 year-old WM who had new-onset
right-sided weakness, leg weaker than
arm, abulia (lack of spontaneity)

Left Anterior Cerebral Artery Infarct (ACA)

Left Anterior Cerebral
Artery (ACA) Infacrt

 69 year-old right-handed BM, brought in by
wife who found patient on floor. When
asked, patient’s only complaint was
headache.
 Examination revealed an awake, alert
patient with anosognosia; left hemineglect;
right gaze preference, inattention to left
field; extinction to double simultaneous
stimulation (visual and sensory) ; left
hemiparesis, arm weaker than leg, left
hemisensory deficits

Right Middle Cerebral Artery (MCA)
Territory Infarct ) Full MCA Stroke

 36 year-old right handed, with h/o
previous DVT’s (deep venous
thrombosis), lethargic, right gaze
deviation, left
hemiplegia, hemisensory, later became
comatose with decerebrate
posturing, anisocoria (right pupil >left)