History of right MCA and PCA strokes. Evaluate vasculature. MRA neck:Conventional arch anatomy. The common carotid artery origins are widely patent. The vertebral artery origins are poorly visualized, but the vertebral arteries are otherwise normal caliber. The left internal carotid artery is normal in caliber throughout. The right internal carotid artery is occluded at its origin. MRA brain:There is partial reconstitution of the ophthalmic and supraclinoid right ICA likely from collateral circulation through the anterior communicating artery. There is minimal flow along the M1 segment of the MCA with no opacification of the m2 segment. The right PCOMA is small. The posterior cerebral arteries are normal in caliber.
1. Complete occlusion of the right internal carotid artery at its origin with occlusion of the right middle cerebral artery with a minor opacification of the right M1 segment only. An underlying cause is not readily identified on this exam.