MRI - MRI Brain and MR angiography
Axial T2
Axial FLAIR
Axial MRA
Coronal MRA
There is bilateral native vertebral artery hypoplasia. A large caliber ascending arterial channel was seen arising from the distal cervical segment of the left internal carotid artery, passing through the left hypoglossal canal and reforming the basilar artery - consistent with persistent hypoglossal artery.
Chronic small vessel ischemic changes are seen in bilateral corona radiata, left thalamus and left centrum semiovale. Chronic lacunar infarcts are seen in head of right caudate nucleus.
Posterior fossa appears normal.