Right internal carotid artery: Decreased caliber of the cervical internal carotid artery at the carotid bulb with a focally increased caliber just prior to the intracranial portion, with a slightly irregular medial projecting outpouching. On the coronal reformatted images, there is slight buckling of the artery proximally.
Left internal carotid artery: No critical narrowing. Focal irregularity of the vessel wall with
narrowing just after the carotid bulb.This is followed by a focal dilation of the vessel wall measuring up to 7.4 cm, with calcification along the anterior margin. Small posterior projecting outpouching may represent a small pseudoaneurysm, which appears to lead to a small, chronic appearing dissection flap along the posterior margin.
Right vertebral artery: Relatively diminished blood flow within the right vertebral artery compared to the left. There focal segmental occlusion of the intracranial/V4 segment, leading to the vertebrobasilar junction.
Left cervical vertebral artery: Slightly dominant left vertebral artery appears patent and is without significant narrowing. No dissection.
Patent intracranial vasculature.