 MRA BRAIN: Again seen is a congenitally hypoplastic left vertebral artery with minimal contribution to the basilar artery. The left PICA artery is not visualized. Very small P-comm arteries are again noted bilaterally. There is a large right vertebral artery which is patent and likely the predominant source of contribution to the posterior circulation. The right PICA artery is visualized. The basilar artery appears within normal limits. Bilateral PCA arteries are patent. The intracranial internal carotid arteries demonstrate no significant stenosis. The middle and anterior cerebral arteries are also patent. No evidence of aneurysms or vascular malformations.MRA NECK: Again demonstrated is a severely hypoplastic left vertebral artery beginning at its origin and extending up along most of its length within the neck. Again seen is a large right vertebral artery which is likely the dominant contribution to the posterior circulation. The carotid arteries within the neck are within normal limits.
1.No evidence of aneurysm, significant steno-occlusive disease or dissection in the arteries of the brain or neck.2.Congenitally hypoplastic left vertebral artery and small bilateral PComm arteries unchanged from the recent head and neck CTA.