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Cerebral Angiography

What is a cerebral angiography?

Cerebral angiography is a diagnostic test that uses an X-ray. It produces a cerebral angiogram, or an image that can help your doctor find blockages or other abnormalities in the blood vessels of your head and neck. Blockages or abnormalities can lead to a stroke or bleeding in the brain.

For this test, a doctor injects a contrast medium into your blood. The contrast material helps the X-ray create a clear picture of your blood vessels so that your doctor can identify any blockages or abnormalities.

Uses

Not everyone who may have arterial blockages needs to have cerebral angiography. It’s usually performed only if your doctor needs more information to plan your treatment after other testing. That’s because it’s invasive and carries some risks.

A newer method
A newer technique for cerebral angiography is called intra-arterial digital subtraction angiography. It’s commonly used because it provides a much clearer picture and requires less contrast dye and radiation.

An angiogram can also be used to help treat some of the conditions involving the blood vessels of the neck and brain. Cerebral angiography can help diagnose:

Cerebral angiography may also help your doctor figure out the cause of certain symptoms, including:

  • stroke
  • severe headaches
  • loss of memory
  • slurred speech
  • dizziness
  • blurred or double vision
  • weakness or numbness
  • loss of balance or coordination

How to prepare

Talk to your doctor about how you should prepare. You may not be able to eat or drink after midnight prior to the procedure.

Before the procedure, your doctor may also ask you to stop taking medications that can increase bleeding risk. These include:

  • blood thinners
  • aspirin
  • nonsteroidal anti-inflammatory drugs

If you’re breastfeeding, pump your milk before the procedure, and don’t breastfeed your child again for at least 24 hours. This wait time will give the contrast material time to leave your body.

Alert your doctor

Tell your doctor if you have certain allergies or medical conditions. Some people are allergic to the contrast material used during the procedure. Tell your doctor if you have any allergies, including allergies to anesthesia or the contrast material given for CT scans. Your doctor may prescribe antiallergy medications before the test.

Certain illnesses and medical conditions can increase your risk of complications during the test. If you have diabetes or kidney disease, the contrast material can cause temporary damage to your kidneys. If you’re pregnant or think you might be, you should ask about radiation exposure during the test.

What to expect during the procedure

Your healthcare team for this test may include a radiologist, a neurosurgeon or neurologist who specializes in interventional radiology, and a radiology technician.

Most people are sedated before the procedure. Others — especially children — are given general anesthesia. This is because you must be still for the test to be effective. The sedation will help you feel relaxed, and you may fall asleep.

During the procedure, your head will be stabilized with a strap, tape, or sandbags. It’s very important to lie still during the test.

To start, your doctor will sterilize an area of your groin. They’ll insert a catheter (a long, flexible tube) and thread it through your blood vessels and into your carotid artery. This is the blood vessel in your neck that carries blood to your brain.

A contrast dye will flow through the catheter and into the artery. From there, it will travel to the blood vessels in your brain. You may have a warm feeling as the contrast dye flows through your body. Then the doctor will take multiple head and neck X-rays. While they take the scans, you may be asked to hold still or even to hold your breath for a few seconds.

Afterward, your doctor will remove the catheter and place a dressing over the insertion site. The entire procedure usually takes one to three hours.

Risks

Cerebral angiography carries some rare but potentially serious risks. They include:

  • stroke (if the catheter loosens plaque inside a blood vessel)
  • damage to the blood vessels, including puncturing an artery
  • blood clots, which can form around the catheter tip

Be sure to discuss all risks carefully with your doctor.

Following up after cerebral angiography

After the procedure, you’ll go to a recovery room where you’ll lie still for two to six hours before going home. At home, be careful not to lift heavy objects or overexert yourself for at least one week.

Call your doctor immediately if you experience any of the following:

  • signs of a stroke, including slurred speech, weakness, numbness, or vision problems
  • redness and swelling at the catheter insertion site
  • swelling or coldness of the leg or foot
  • chest pain
  • dizziness

When your results are available, a radiologist will interpret them. Your doctor will share these results with you and discuss follow-up tests or treatment.

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