 The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. However the post-PICA left V4 segment is diminutive. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.MRA NECK
1. No evidence for acute ischemia.2. Numerous foci of T2/FLAIR hyperintensity in the periventricular and subcortical white matter as well as pons are nonspecific however may be related to chronic microvascular ischemic disease.3. MRA of the head and neck are negative for evidence of steno-occlusive disease, with limited evaluation of right common carotid origin.4. Left sphenoid sinus disease.5. Heterogeneous thyroid gland. Further evaluation with thyroid ultrasound may be considered as clinically indicated.