CT Carotid Angiogram
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The aortic arch is normal in appearance. The left vertebral artery arises from the arch as a normal anatomical variant.
The left common, internal and external carotid arteries are patent. The right internal and external carotid arteries arise separately from the brachiocephalic trunk, with the right internal carotid artery being extremely small in diameter, measuring only 1.5 mm, although the vessel appears patent throughout. The diameter of the carotid canal is reduced significantly, appearances are in keeping with congenital hypoplastic right ICA.
Patent and normal in course and size.
The MCA vessels are normal in calibre bilaterally. Foetal origin of the right PCA and prominent right P1 suggesting the right MCA is being supplied primarily from the posterior circulation. Foetal origin of the left PCA, which is normal in calibre. Fenestrated ACOM.
Hypoplastic right internal carotid. No dissection.