MCA territory infarct
Acute left-sided hemiplegia ( < 5 days) in diabetic and hypertensive patient.
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There is a large infarct in the distribution of the right middle cerebral territory of low signal on T1, high signal on T2 and FLAIR with restricted diffusion and no hemorrhagic component on GE sequence. MRA shows occlusion of the right middle cerebral artery beyond the M1 segment.
Small vessel chronic ischemic changes and lacunar infarcts are also noted.
The MCA territory is the most commonly affected in cerebral infarction, due to its size and the direct flow from the ICA into the MCA, providing the easiest path for thromboembolism.