 There is flow within the bilateral vertebral arteries. The right vertebral artery is dominant. The post PICA left V4 segment appears diminutive, though this is likely congenital in etiology. There is irregularity of the left PICA just distal to its origin.Further, there is also appropriate flow within the basilar artery, distal bilateral internal carotid arteries. The right A1 segment appears diminutive, and the A2 segment is not visualized shortly after its origin. There is redemonstration of occlusion of the left MCA within the mid M1 segment with distal perfusion likely provided by collateral branches. This correlates with prior loss of flow void seen on old imaging. No arterial arteriovenous malformations or aneurysms are identified.
1. Persistent complete occlusion of the left MCA at the mid M1 segment.2. Redemonstration of occluded of right A2 segment.3. Partially visualized left PICA atherosclerotic irregularity.