CT
Axial C+ arterial phase
Sagittal C+ arterial phase
Axial C+ delayed
Sagittal C+ delayed
Axial CT perfusion summary
Axial CT perfusion - MTT
Axial CT perfusion - CBF
Axial CT perfusion - CBV
CTA and CT perfusion performed with the patient's head rotated towards right (not intentional - uncooperative patient).
CTA demonstrates occlusion of right cervical ICA due to compression by calcified stylohyoid ligament. Right supraclinoid ICA non-opacified. Right MCA and ICA patent via circle of Willis.
CT perfusion demonstrates right MCA territory hypoperfusion (increased MTT, decreased CBF, normal CBV). No appreciable critical hypoperfusion (normal CBV). Of note, no acute left MCA territory perfusion abnormality to correlate with the patient's presentation (right hemiparesis - the clinical data was confirmed with the referring doctor).
Post contrast CT brain delayed phase performed with the patient's head in neutral position: The right ICA is now patent at level of stylohyoid ligament and above.