Infarcts in the lateral striate artery (LSA) territory can be caused by several pathological changes, including lipohyalinosis and microatheroma. However, fluid dynamic effects on these changes remain unknown. Thus, we investigated whether the fluid dynamic metrics of the LSAs were altered in patients with acute ischemic stroke using computational fluid dynamics (CFD) analysis.Fifty-one patients with acute ischemic stroke confined in the basal ganglia and/or corona radiata underwent high-resolution magnetic resonance angiography (HR-MRA) at 7T. We performed CFD analyses to obtain indices including the wall shear stress (WSS), WSS gradient (WSSG), and flow velocity (FV) and compared these values between the ipsilesional and contralesional sides in the patients with infarcts in the LSA or non-LSA territories.In patients with LSA-territory infarcts, the WSS, WSSG, and FV values were significantly lower in the ipsilesional LSAs than in the contralesional LSAs (P = .01-.03), while these values in the proximal middle cerebral arteries showed no significant lateralities. In contrast, in patients with non-LSA-territory infarcts, there were no significant lateralities in the metrics between the ipsilesional and contralesional sides.The CFD analyses using HR-MRA revealed significantly low WSS and WSSG values of the ipsilesional LSAs compared with that of the contralesional side in patients with LSA-territory infarcts, suggesting that fluid dynamic factors of LSAs can be one of the risk factors for LSA-territory infarctions.