Wernicke's or transcortical sensory aphasia plus right face/arm sensory loss and right visual field defect. Which stroke territory is most likely?

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The key idea is how stroke territory maps to both language and sensory/visual functions. Language in this scenario is impaired in a fluent way (Wernicke’s or transcortical sensory aphasia), which localizes to the left temporoparietal region. The primary somatosensory cortex for the face and arm is also on the left lateral parietal surface and is supplied by the MCA. A visual field defect on the right indicates involvement of the left optic radiations or nearby occipital/parietal pathways, again within MCA territory.

Among MCA territory strokes, the inferior division on the left specifically affects the temporoparietal region that houses Wernicke’s area and can produce sensory or transcortical sensory aphasia, while also producing contralateral sensory loss and visual field defects due to involvement of adjacent radiations. In contrast, a left MCA superior division would more classically cause language production problems (Broca’s aphasia) with prominent face/arm weakness, not receptive aphasia. PCA involvement would more typically give prominent visual cortical deficits with less aphasia. Therefore, the pattern fits a left MCA inferior division stroke.