Which artery is most commonly affected in ischemic strokes?

The middle cerebral artery is the most commonly affected vessel in ischemic strokes, which are often classified as either embolic or thrombotic in nature. This artery supplies a substantial portion of the lateral aspect of the cerebral hemisphere, including critical areas responsible for motor and sensory functions, as well as language and higher cognitive functions.

Ischemic strokes typically result from a blockage that reduces blood flow to specific areas of the brain, leading to tissue damage. Given that the middle cerebral artery supplies a large region, an occlusion can cause extensive deficits. For example, a stroke in this artery can lead to contralateral hemiparesis or hemiplegia, particularly affecting the arm and face more than the leg, which is a characteristic presentation.

While other arteries like the anterior cerebral artery, posterior cerebral artery, and basilar artery can also be involved in strokes, they are less frequently the site of occlusion compared to the middle cerebral artery. The anterior cerebral artery typically affects the lower limb, while the posterior cerebral artery may lead to visual deficits, and the basilar artery is more often associated with brainstem strokes, which can result in different clinical symptoms. Thus, the prevalence and the clinical impact of occlusion in the middle cerebral artery make it