A middle cerebral artery (MCA) stroke occurs when the MCA, a large artery that supplies blood to the sides of the brain, ruptures or becomes blocked. Symptoms include weakness, confusion, and speech issues.

A 2023 overview of research states that the MCA is the most common artery involved in a stroke. Its main function is to supply oxygenated blood to specific brain regions.

This article provides an in-depth look at the symptoms, causes, and risk factors for strokes that affect the MCA. It also describes diagnosis methods, treatment options, possible complications, prevention, and the outlook for people who have an MCA stroke.

An angiography showing the cerebral middle artery -2Share on Pinterest
mr.suphachai praserdumrongchai/Getty Images

According to the Centres for Disease Control and Prevention (CDC), typical stroke symptoms include sudden onset of the following:

  • weakness in the arm, leg, or face
  • walking problems
  • vision problems
  • dizziness
  • confusion
  • difficulty speaking or understanding speech
  • severe headache, also known as a thunderclap headache

People may also experience sensory loss on one side of the body.

Learn more about the symptoms of a stroke.

Left vs. right MCA

Each MCA is a branch of the internal carotid artery. Stroke symptoms appear on the opposite side of the body to the side of the MCA a stroke affects.

For instance, weakness of the left arm indicates a right-sided stroke, whereas weakness of the right arm indicates a left-sided one.

Strokes affecting the left side of the MCA may be more severe than those that affect the right. According to a 2022 study, those with left MCA strokes scored higher on the National Institutes of Health Stroke Scale, an assessment tool healthcare professionals use to assess the severity of a stroke.

As a recent review explains, there are two main types of stroke.

Ischemic strokes occur when a blood clot blocks a blood vessel in the brain or if the blood vessel becomes too narrow. Hemorrhagic strokes occur when a blood vessel in the brain bursts or bleeds.

Stroke can arise from causes such as:

According to a 2023 article, the following factors elevate a person’s risk of experiencing a stroke:

  • being older
  • having a family history of stroke or conditions such as cerebral arterial disease
  • having certain genetic conditions, including sickle cell disease

Other risk factors include

It is important to note that stroke risk factors are not necessarily causes of stroke. Furthermore, having these risk factors does not make it certain that an individual will experience a stroke.

Research suggests several techniques are helpful in diagnosing an acute stroke. These include imaging studies, such as MRI and CT scans. Imaging studies help doctors determine the size, location, and type of stroke.

Doctors will also want to perform some blood tests. These can help them determine the cause of an MCA stroke and factors that might be contributing to a person’s symptoms.

Some useful blood tests include:

  • a coagulation panel
  • complete blood counts
  • basic metabolic panels
  • blood glucose levels

Once doctors have diagnosed a stroke, they may send the person for additional cardiac testing to look for cardiac risk factors for stroke, such as atrial fibrillation.

According to the 2023 overview of research, there are three main aspects to stroke treatment.

The first is treating the acute stroke itself. The doctor’s aim is to save the person’s life and limit any brain damage from the stroke.

Doctors can do this by combining IV tissue plasminogen activator (tPA) therapy, a pharmaceutical approach, with a thrombectomy. During a thrombectomy, doctors surgically remove a clot.

The second aspect is preventing another stroke from occurring. This longer-term form of treatment focuses on minimizing stroke risk factors.

The third aspect of treatment is to address any long-term complications of a stroke. These can result from brain damage and include speech and movement difficulties. Even with specialized physical therapy, this process can take up to a year.

The outlook for a person who has an MCA stroke can depend on the severity of the stroke and the individual’s overall health. Responsiveness to treatment is also an important element.

In people whose MCA strokes are not very severe, recovery is possible. However, the odds of recovery are very low for those who experience a very severe MCA stroke.

The same is true of survival rates, which depend on certain life-saving measures. These include tracheostomy, where doctors create an opening at the front of the neck and insert a tube into the windpipe to help with breathing, and percutaneous gastrostomy tube placement, which is the insertion of a feeding tube.

There is no way for an individual to completely prevent having a stroke. However, because certain stroke risk factors are modifiable, some individuals could help prevent strokes by avoiding such factors.

According to the 2023 article, the following are modifiable stroke risk factors:

  • smoking
  • drinking alcohol
  • not exercising regularly
  • not eating a healthy diet
  • having any of the following:

It may not always be possible or practical to avoid these risk factors. Individuals who want to lower their stroke risk can discuss what might help with a doctor.

Complications affect around 85% of people who have had an MCA stroke.

The most common complications among people who receive MCA stroke treatment in a hospital are:

In the months that follow discharge from the hospital, these remain common. Psychological complications such as depression and anxiety also tend to become more likely.

A stroke is a medical emergency. The CDC urges that anyone with signs of stroke immediately call 911. Getting prompt treatment could save their life and limit the long-term effects of stroke.

Some people who have a stroke will be unable to contact emergency services. Anyone who sees a person they suspect may be having a stroke should do so for them.

A middle cerebral artery (MCA) stroke occurs in the MCA, an artery deep in the brain’s cerebral cortex. It is the most common artery involved in a stroke.

People who experience an MCA stroke may show signs of dizziness, confusion, or lack of coordination. They may also have weakness in the arms or legs. Physical symptoms only affect one side of the body.

Treatment for MCA strokes is complex. After stabilizing the person’s condition, doctors will want to lower the chances of another stroke occurring. They will also recommend physical therapy to help with any disability resulting from the MCA stroke. This process can take several months.