No intracranial vascular occlusion identified. High-grade stenosis due to calcified and noncalcified plaque of the dominant right V4. The nondominant left vertebral artery terminates as a PICA. Heavily calcified right vertebral artery, bilateral cavernous ICAs and right terminal ICA. The right common carotid artery bifurcation demonstrates irregular calcified and noncalcified plaque which extends into the proximal ICA causing a high-grade ICA stenosis. Surgical clips anterior to the left carotid sheath. Dural venous sinuses enhance normally.