 MRA Brain:The A1 segment of the left ACA shows irregular multifocal narrowings. The ACOM is normal. The A2 segment of left ACA also shows multifocal luminal narrowings and irregularities. The left pericallosal and calloso-marginal arteries are not clearly delineated.The M1 segment of bilateral middle cerebral arteries show multifocal luminal stenosis. The degree of stenosis is more than 50% in some lesions. However, the distal flow appears to be maintained.There is long segment narrowing and irregularity of the basilar artery which is significantly stenotic, the degree of stenosis appears to be more than 75%.The right distal vertebral artery demonstrates irregular luminal narrowing and the right vertebrobasilar junction is not visualized. The left vertebral artery is not seen.Contrast enhanced neck MRI is non-diagnostic due to arterial bolus of contrast was missed for arterial phase imaging. If clinical concern persists, recommend MRA neck for complete evaluation. This will be performed without additional charge.
Multifocal anterior and posterior circulation luminal narrowing and stenosis compatible with atherosclerotic changes as described.Possible high grade basilar artery stenosis.No intracranial aneurysm was found. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.