Female, 55 years old, with new left-sided headache. No evidence edema, mass effect, focal signal abnormality or diffusion restriction is seen. The pattern of intracranial enhancement is within normal limits. No findings to suggest intracranial hemorrhage or any abnormal extra-axial fluid collection are observed. Ventricular size and morphology are within normal limits.MRA images of the head demonstrate congenital hypoplasia of the left vertebral artery which primarily supplies the left PICA. No significant intracranial vascular stenosis or occlusion is seen. A small laterally directed outpouching from the proximal right ACA at the origin of the orbitofrontal branch most likely represents an infundibulum. No other definite aneurysm or vascular malformation is observed.MRA images of the neck demonstrate conventional aortic branching. The origins of the great vessels are patent. No significant stenosis is detected in the carotid vessels by NASCET criteria. Likewise, the vertebral vessels are patent throughout. The left vertebral artery is congenitally small.
1.No brain parenchymal abnormalities.2.No abnormalities of the intracranial or neck vessels.