Which arterial territory infarction is the most common and presents with contralateral hemiparesis and hemisensory loss, with aphasia if the left hemisphere is affected or neglect if the right hemisphere is affected?

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The key idea is that the middle cerebral artery supplies the lateral aspects of the frontal and parietal lobes, including the primary motor and sensory areas for the face and arm, and, in the dominant hemisphere, the language centers. An infarct here typically produces contralateral weakness and sensory loss, especially affecting the face and arm. If the dominant (usually left) hemisphere is involved, language areas are affected, causing aphasia. If the nondominant (usually right) hemisphere is involved, parietal regions can produce hemispatial neglect. Since the leg areas are more medial and supplied by the anterior cerebral artery, leg weakness is less prominent in MCA strokes. Other arteries cause different patterns: anterior cerebral artery strokes emphasize leg weakness and behavioral changes; basilar artery strokes affect brainstem or cerebellar functions; posterior cerebral artery strokes often produce visual field deficits and memory issues rather than the language or neglect patterns.