Cerebral angiography, also called cerebral arteriogram, is a diagnostic test that can help your doctor find blockages in the blood vessels of your head and neck. These blockages can lead to a stroke or aneurysm.
Using the catheter (a long, flexible tube), your doctor will inject a contrast dye into your carotid artery. The carotid artery is the blood vessel in your neck that carries blood to your brain. The contrast material helps the X-ray create a clear picture of your blood vessels so that your doctor can identify any blockages.
A newer technique for cerebral angiography is called intra-arterial digital subtraction angiography. It’s commonly used because it requires less contrast dye and smaller catheters.
Not everyone who may have arterial blockages needs cerebral angiography. It’s usually performed only if your doctor needs more information to plan your treatment after noninvasive testing. That’s because it’s invasive and carries some risks.
Cerebral angiography can help diagnose:
- an aneurysm (a rupture in the wall of an artery)
- arteriosclerosis (narrowing of the arteries)
- an arteriovenous malformation (a mass of dilated interconnected blood vessels)
- vasculitis (blood vessel inflammation)
- blood clots
- tears in the lining of an artery
Cerebral angiography may also help your doctor figure out the cause of certain symptoms, including:
- severe headaches
- loss of memory
- slurred speech
- blurred or double vision
- weakness or numbness
- loss of balance or coordination
You may not be able to eat or drink after midnight prior to the procedure. Talk to your doctor about how you should prepare.
Before the procedure, your doctor may ask you to stop taking medications that can increase bleeding risk. These include:
- blood thinners
- nonsteroidal anti-inflammatory drugs
Some people are allergic to the contrast material used during the procedure. Tell your doctor if you have any allergies, including allergies to anesthesia. Your doctor may prescribe anti-allergy medications before the test.
Certain illnesses and medical conditions can increase your risk of complications during the test. The contrast material can cause temporary damage to your kidneys if you have diabetes or kidney disease. Women who are pregnant or think they might be should ask about radiation exposure during the test.
If you’re breastfeeding, pump your milk before the procedure and don’t breastfeed again for at least 24 hours. This will give the contrast material time to leave your body.
Your healthcare team for this test may include a radiologist, a neurosurgeon who specializes in interventional radiology, and a radiology technician.
Most people are sedated during 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.
Your doctor will sterilize an area of your groin. They’ll insert a catheter and thread it through your blood vessels and into your carotid artery, which is located in your neck.
A contrast dye will flow through the catheter and into the artery, where it will travel to the blood vessels in your brain. You may have a warm feeling as the contrast dye flows through your body. Multiple head and neck X-rays will be taken.
Afterward, your doctor will remove the catheter and place a dressing over the insertion site. The entire procedure usually takes one to three hours.
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 carefully discuss all risks with your doctor.
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 the following:
- signs of a stroke (including slurred speech, weakness or numbness, or vision problems)
- redness and swelling at the catheter insertion site
- chest pain
A radiologist will interpret the results of your test. Your doctor will share these results with you and discuss follow-up tests or treatment.