Middle Cerebral Artery Damage in Stroke with Arm, Leg, and Face Weakness

Clinical Presentation and Diagnosis

In a stroke case presenting with weakness in the arm, leg, and face, the damage is most likely located in the middle cerebral artery (MCA) territory, according to the International Journal of Stroke guidelines 1, 2
Urgent brain imaging (CT or MRI) and noninvasive vascular imaging (CTA or MRA from aortic arch to vertex) should be completed as soon as possible within 24 hours to confirm MCA territory involvement, as recommended by the International Journal of Stroke 3

Patients with large MCA infarctions may develop malignant cerebral edema requiring consideration for decompressive hemicraniectomy, especially in patients under 60 years, as suggested by the International Journal of Stroke guidelines 1, 2
Immediate transfer to an emergency department with advanced stroke care capabilities is essential for patients presenting with this pattern of weakness, according to the International Journal of Stroke 3