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Diagnostic provocative cerebral angiogram shows the left vertebral artery with the head positioned straight (A), turned to the right (B) and turned to the left (C). There is complete patency of the left vertebral artery with the head positioned straight and turned to the right. However, there is 100% stenosis of the left vertebral artery at the level of C4-C5 (white circle) with the patient's head turned to the left.
