Which blood vessel is most frequently involved in strokes?

The middle cerebral artery is the most frequently involved vessel in strokes due to its large territory, which supplies a significant portion of the lateral aspects of the cerebral hemispheres, including areas responsible for motor and sensory functions, as well as language in the dominant hemisphere. Its anatomical positioning makes it susceptible to occlusion from emboli or thrombi, leading to ischemic strokes.

In particular, the middle cerebral artery is a common site for embolic strokes since it is a major artery that branches off the internal carotid artery, thereby receiving a substantial amount of blood flow. Strokes in this vessel typically result in pronounced motor deficits, contralateral hemiplegia, and aphasia if the dominant hemisphere is affected, which contributes to its frequency as the culprit in strokes.