A cerebral angiogram is a diagnostic procedure that provides images of the blood vessels in the brain and/or head. The test is performed to search for blocked or leaking blood vessels. This test can help to diagnose such conditions as blood clotting, fatty plaque which increases a patient's risk of stroke, cerebral aneurysm or other vascular malformations.
The procedure is done to see if there is blockage in the arteries of the brain. It also provides information of how severe the blockage is. The procedure is used to detect or confirm abnormalities within the blood vessels in the brain, including: -An aneurysm, a bulge or sac that develops in an artery due to weakness of the arterial wall. -Atherosclerosis, a narrowing of the arteries. -Arteriovenous malformation, a tangle of dilated blood vessels that disrupts normal blood flow in the brain. -Vasculitis, an inflammation of the blood vessels, generally narrowing them. -A brain tumor. -A blood clot. -A tear in the wall of an artery, known as a vascular dissection. -A stroke. A cerebral angiogram may be also performed: -To evaluate arteries of the head and neck before surgery. -To provide additional information on abnormalities seen on MRI or CT of the head, such as the blood supply to a tumor. -To prepare for other medical treatment, such as in the surgical removal of a tumor. -To prepare for minimally invasive treatment of a vessel abnormality.
-Angiography may eliminate the need for surgery. If surgery remains necessary, it can be performed more accurately. -Cerebral angiography presents a very detailed, clear and accurate picture of blood vessels in the brain. This is especially helpful when a surgical procedure or other treatment is being considered. -Results from cerebral angiography are more accurate than those produced by carotidDoppler ultrasoundor other noninvasive imaging of the blood vessels. -Use of a catheter makes it possible to combine diagnosis and treatment in a single procedure. -No radiation remains in a patient's body after an x-ray examination. -X-rays usually have no side effects in the typical diagnostic range for this exam.
-There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk. -There is a very slight risk of an allergic reaction if contrast material is injected. If you have a history of allergy to x-ray contrast material, your radiologist may advise that you take special medication for 24 hours before cerebral angiography to lessen the risk of allergic reaction. However, the risk of an allergic reaction from contrast material injected into an artery is less than if it is introduced into a vein. -Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. See the Safety in X-ray, Interventional Radiology and -The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well equipped to deal with them. -If you have diabetes or kidney disease, the kidneys may be injured due to the contrast material. In most cases, the kidneys will regain their normal function within five to seven days. -Any procedure that places a catheter inside a blood vessel carries certain risks. These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection. The doctor will take precautions to mitigate these risks. -There is a small risk that blood will form a clot around the tip of the catheter, blocking the artery and making it necessary to operate to reopen the vessel. -There is a risk of stroke with this procedure if the catheter dislodges plaque from a vessel wall that blocks blood flow within the brain. Although stroke may be a complication associated with cerebral angiography, it is uncommon. -Rarely, the catheter punctures the artery, causing internal bleeding. It also is possible that the catheter tip will separate material from the inner lining of the artery, causing a block downstream in the blood vessel.
The procedure is performed either through the groin or the wrist or the front part of the elbow. The right side is preferable. It is done using local anesthesia. During the procedure, a small catheter is introduced to the root of the carotid artery. Contrast agent is injected directly into the blood vessels of the brain. Pictures are taken during the contrast injection.
Your docttor will discuss with you about any reactions to any contrast dye, or if you are allergic to iodine or shellfish. Tell your doctor if you are sensitive to or are allergic to any medicines, latex, tape, and anesthetic agents (local and general). You will need to fast (not eat) for a certain time prior to the procedure. Yourdoctor will tell you how long to fast, whether for a few hours or overnight. If you are female, make sure to tell your doctor if you are pregnant or think you may be. You may be given a medicine to relax you and make you sleepy before the procedure. You may also receive an anticholinergic medicine, which slows down the production of saliva in the mouth, blocks the production of acid in the stomach, and slows down the activities of the intestinal tract, among other effects. If you get this medicine, you may notice that your mouth feels dry. The doctor will also discuss whether you have any history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. You may need to stop these medicines before the procedure. Depending on the site used for injection of the contrast dye, the recovery period may last up to 12 to 24 hours. You should be ready to spend the night if necessary. The doctor may request a blood test prior to the procedure to see how long it takes your blood to clot.
Depending on which site was used for injection of the contrast dye, you will stay flat in bed in a recovery room for several hours after the procedure. If the groin or arm site was used, the leg or arm on that side will be kept straight for up to 12 hours. If the neck was used, you will be watched for signs of hoarseness, breathing problems, or pain or difficulty in swallowing. The nurse will monitor your vital signs, your neurological signs, and the injection site while you are in the recovery room. You may be given pain medicine for pain or discomfort related to the injection site or pain from having to lie flat and still for a long period. You will be encouraged to drink water and other fluids to help flush the contrast dye from your body. You may go back to your usual diet and activities after the procedure, unless your doctor tells you otherwise.
The chance of a complication with a cerebral angiogram is small. However, it is important to be aware of the possible risks, including but not limited to: internal bleeding, damage to a blood vessel, infection, allergic reaction to the contrast dye, and stroke. Of course your physician will be carefully monitoring for any complications and is fully trained to respond if one arises.
What kinds of patients are eligible for cerebral angiograms?
Patients with the following conditions may have a cerebral angiogram performed: Transient Ischemic Stroke Carotid disease Acute Stroke (sudden onset of numbness or weakness face arm leg onside of body, facial droop, sudden confusion, trouble speaking or understanding, trouble seeing in one or both eyes or double vision, severe headache with no known cause, difficulty swallowing)
How do coronary angiograms work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special detector. Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black. Most x-ray images are digital files that are stored electronically. These stored images are easily accessible for diagnosis and disease management. Fluoroscopy uses a continuous or pulsed x-ray beam to create a sequence of images that are projected onto a fluorescent screen, or television-like monitor. When used with a contrast material, which clearly defines the area being examined by making it appear dark (or by electronically reversing the image contrast to white), this special x-ray technique makes it possible for the physician to view joints or internal organs in motion. Still images or movies are also captured and stored electronically on a computer.