Where is the most common site for an ischemic stroke?

The middle cerebral artery is the most common site for an ischemic stroke due to its substantial perfusion area, which encompasses a large portion of the lateral cerebral hemisphere. This artery supplies blood to critical regions responsible for motor and sensory functions, language, and spatial awareness. As a result, occlusion or blockage in this vessel commonly leads to significant neurological deficits, particularly affecting upper limb and facial muscles on the contralateral side, as well as speech and comprehension in individuals with dominant hemisphere involvement.

The anterior cerebral artery, while also significant, primarily supplies the medial aspects of the frontal lobes and the superior medial parietal lobes. Its occlusion tends to lead to less dramatic functional impairments compared to those stemming from issues in the middle cerebral artery. Similarly, the posterior cerebral artery and the basilar artery have more localized territories which tend to result in less frequent strokes when compared to the high incidence associated with the middle cerebral artery. Thus, the anatomical and functional implications of the middle cerebral artery's distribution highlight its role as the most frequent site for ischemic strokes.