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Near complete obliteration of contrast opacification within the carotid canal. No supraclinoid portion visible. Poor opacification of the right M1 which is presumably filling from leptomeningeal collaterals. Marked paucity of M3 and distal MCA branches along the convexity.
Near complete obliteration of contrast opacification within the carotid canal. Distal supraclinoid ICA reconstitution via the left P-comm gives rise to a dominant left anterior cerebral artery and normal calibre middle cerebral artery. Hypoplastic right vertebral artery. Dominant left vertebral artery. Normal calibre basilar artery. A prominent left posterior communicating artery supplies retrograde flow to the supraclinoid left internal carotid artery.
Conclusion: The imaging findings are most likely in keeping with a Moya-Moya type phenomenon.