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Vascular Surgery

Constant head pressure and MRA study




I am a 25yo male, 6`2" 160lbs., do not have high blood pressure, cholesterol, or triglycerides. used to workout and be very active, drank alcohol 2-3x week, never smoked cigarettes. 3 yrs ago I started having head pressure 24/7 after a night with some friends celebrating with some drinks. 3 yrs later, not a day has passed w/o the head pressure. I had 2 brain MRIs (normal), 1 brain CT (normal), 2 MRIs cervical (disc bulges, annular tears, muscle spasms, etc), 1 EKG (normal), complete blood test (normal). Recently I just had a head MRA and need some help interpreting:

Findings: There is no filling of the right A1 segment. There is no right posterior communicating artery. There is filling of the left A1 segment which supplies both the right and left anterior cerebral arteries.

Both vertebral arteries fill and the distal left vertebral artery is slightly larger than right consistent with developmental variation. The basilar artery fills. Basilar arterial bifurcation is patent. There is filling of bilateral posterior cerebral arteries as well as anterior inferior cerebellar arteries. Source imaging demonstrates a very scant tiny left posterior communicating artery. There is no right posterior communicating artery.

IMPRESSION: There is isolated filling of the right middle cerebral arterial circulation to the right internal carotid artery representing isolated circulation due to absence of the right A1 segment of the right posterior communicating artery, which is consistent with developmental variation.

everything else was unremmarkable it said. can you help with an interpretation? god bless


Though I am not a radiologist nor neurosurgeon, the final impression of the MRI sounds relatively normal with just some variation in your arterial anatomy - common among many people. Would recommend you seek an opinion from a neurologist if you haven't already. Good Luck!

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Response by:

Amy B Reed, MD Amy B Reed, MD
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