Superior Division Left MCA

• Broca’s Aphasia
• Leftward Attentional Bias (leftward gaze, right hemispatial neglect)
• Right Facial & Arm/Hand Paresis
• Mechanism: embolism & intracranial atherosclerosis

Superior Division Right MCA

• Rightward Attentional Bias (rightward gaze, multi-modal left hemispatial neglect)
• Right Facial & Arm/Hand paresis
• Aprosody
• Mechanism: embolism & intracranial atherosclerosis

Inferior Division Left MCA

• Wernicke’s Aphasia
• Leftward Attentional Bias (leftward gaze, right hemispatial neglect)
• Right Sensorimotor symptoms/signs may be present
• Mechanism: embolism & intracranial atherosclerosis

Infererior Division Right MCA

• Rightward Attentional Bias (rightward gaze, multimodal left hemispatial neglect)
• Left Sensorimotor symptoms/signs may be present
• Mechanism: embolism & intracranial atherosclerosis

Left ACA

• Abulia, may result mutism
• Right hemiparesis, usually leg>arm; however, 30% face-arm-leg equally involved
• Mechanism: embolism & intracranial atherosclerosis

Right ACA

• Abulia, may result in motor neglect
• Left hemiparesis, usually leg>arm; however, 30% face-arm-leg equally involved
• Mechanism: embolism & intracranial atherosclerosis

Left PCA

• Right hemianopsia
• Confusion from amnesia, if hippocampus involved
• Right Hemisensory loss, if thalamus involved
• Mechanism: embolism & intracranial atherosclerosis

Right PCA

• Left hemianopsia
• Confusion from amnesia, if hippocampus involved
• Left Hemisensory loss, if thalamus involved
• Mechanism: embolism & intracranial atherosclerosis

MCA Perforators: Lenticulostriates

• Hemiparesis (face-arm-leg and dysarthria to varying degrees)
• Hemisensory symptoms/signs vary
• Occasionally ataxic-hemiparesis, instead of just hemiparesis
• Mechanism: small vessel disease; can also be from parent M1 disease (atherosclerosis); embolism possible especially if infarct large

Anterior Choroidal Artery

• Hemiparesis (face-arm-leg and dysarthria to varying degrees)
• Hemisensory
• Full territory also includes amnesia (hippocampus), visual field defect (LGN)
• Mechanism: if branch only the small vessel disease; if full territory then can be embolism, intracranial atherosclerosis or small vessel disease

Lateral Thalamic

• Hemisensory
• Occasional hemisensory + ataxic hemiparesis
• Mechanism: if isolated small vessel disease, if part of PCA then embolism & atherosclerosis too

Anterior Thalamic (Tuberothalamic artery)

• Amnesia
• Abulia
• Aphasia (left); hemispatial neglect (right)
• Variable sensorimotor symptoms/signs
• Mechanism: variable – can be small vessel disease, embolism or intracranial atherosclerosis

Medial Thalamus (Artery of Percheron)

• Amnesia
• In-Attention/impaired arousal
• Aphasia (left); hemispatial neglect (right)
• Vertical Gaze Paresis
• Variable sensorimotor symptoms/signs
• Mechanism embolism

Posterior Choroidal

• Rare
• Visual field cut
• Variable sensorimotor symptoms/signs
• Neuropsychological: amnesia, aphasia (left), hemispatial neglect (right)

Paramedian Pons

• Hemiparesis (face-arm-leg and dysarthria to varying degrees)
• Occasionally, ataxic-hemiparesis
• Mechanism: small vessel disease, intracranial atherosclerosis