From the Guidelines
Symptoms of a Middle Cerebral Artery (MCA) infarction typically include contralateral hemiparesis, contralateral hemisensory loss, homonymous hemianopia, and aphasia or neglect, depending on the hemisphere affected. These symptoms can vary in severity and presentation, but generally include weakness on the opposite side of the body from the stroke, with the face and arm usually more affected than the leg 1. Patients may also experience speech and language deficits, such as expressive or receptive aphasia, and spatial neglect, where they ignore or are unaware of one side of their body or environment 1. Additionally, patients may experience dysarthria, dysphagia, and sometimes seizures or headache, depending on the exact location and extent of the infarct within the MCA territory 1.
Clinical Presentation
The clinical presentation of an MCA infarction can be variable, but common symptoms include:
- Contralateral hemiparesis
- Contralateral hemisensory loss
- Homonymous hemianopia
- Aphasia or neglect, depending on the hemisphere affected
- Speech and language deficits, such as expressive or receptive aphasia
- Spatial neglect
- Dysarthria
- Dysphagia
- Seizures or headache
Importance of Early Diagnosis
Early diagnosis and treatment of MCA infarction are critical to improving outcomes and reducing morbidity and mortality 1. The use of brain imaging, such as CT or MRI, can help to confirm the diagnosis and identify the location and extent of the infarct 1. The National Institutes of Health Stroke Scale (NIHSS) can also be used to assess the severity of the stroke and predict outcomes 1.
Prognosis and Treatment
The prognosis and treatment of MCA infarction depend on the severity and location of the infarct, as well as the patient's overall health and medical history 1. Treatment may include thrombolytic therapy, anticoagulation, and supportive care, such as speech and language therapy, physical therapy, and occupational therapy. Early recognition and treatment of MCA infarction can significantly improve outcomes and reduce the risk of long-term disability and mortality 1.
From the Research
Symptoms of Middle Cerebral Artery (MCA) Infarction
- Symptoms of MCA infarction can vary, but common presentations include:
- The severity of symptoms can also vary, with some patients experiencing severe symptoms, such as those with an NIH Stroke Scale (NIHSS) score of 17 or 26 2, 4
- In some cases, patients with chronic MCA occlusion may not present with severe symptoms, but early recanalization of acute occlusion can be associated with high morbidity and mortality 5
- The location and severity of MCA disease can also influence the mechanism of stroke and the resulting symptoms, with proximal MCA disease often associated with a combined mechanism of stroke and distal MCA disease associated with artery-to-artery embolism/hemodynamic infarction 6