The brain being shown here was obtained from a 75 year old man who has a 10 year history of right hemiparesis. What is the most likely gross diagnosis?

A.  Resolved infarction of the left anterior cerebral artery (ACA) territory.

B.  Resolved infarction of the left middle cerebral artery (MCA) territory.

C.  Resolved infarction of the left posterior cerebral artery (PCA) territory.

D.  Resolved infarction of the left anterior choroidal artery territory.

E.  Resolved infarction of the left thalamic perforating artery territory.

Answer and Discussion: The answer is (B). This is clearly a resolved infarct of the left middle cerebral artery. This is a very common site for massive infarction. The motor strip is destroyed leading to hemipararesis.