 The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The P1 segments are hypoplastic and the ACOM artery is not well seen and may be hypoplastic/aplastic which are developmental variants. Again seen is irregularity and moderate segmental narrowing of the left mid to distal P2 segment which is unchanged. The vertebral arteries, basilar artery, and right posterior cerebral artery are normal in course and caliber. There is no other evidence of flow-limiting stenosis or aneurysm.
Irregularity and moderate multifocal narrowing of the left mid to distal P2 segment which is unchanged. No changes compared to the MRA from 5/4/2016.