Cerebral Angiogram

What is a cerebral angiogram? 

A cerebral angiogram is a specialized diagnostic service for brain vessels. It is used to see the blood vessels in the head, brain, and neck. This minimally invasive procedure allows for very detailed imaging of the brain’s small arteries and veins. It also allows for the flow of the blood through the brain to be seen in real time. 

This procedure is usually done under mild sedation. A catheter (which is a thin and long plastic tube) is inserted into an artery that supplies blood to the brain. A special contrast dye is injected through the catheter and flows along with the blood into the different small arteries and vessels. This dye allows the blood vessels in the brain to be seen on the X-ray image. You may feel sensations of warmth during the injection of the contrast dye. The whole process is recorded and can be analysed by doctors to look for anomalies in the blood vessels. 

What can you expect?

Cerebral angiograms are usually out-patient procedures meaning that the patient would be admitted in the morning and discharged before the end of the day. During the procedure you will not be under full anaesthetic, instead the doctor may put some light sedation or local anesthetic at the site of injection. When the contrast dye is injected you may see flashing lights in one eye. This is completely normal and is related to the contrast dye. Do let your doctor know if you feel any discomfort or pain during the procedure.

After the procedure, you may be allowed some food or drink but will have to lie flat for about four to six hours. You should avoid doing anything strenuous for the 48 hours after you have been discharged from the surgery center. Around the area where the catheter was inserted, it is common to experience bruising and soreness. This will diminish as the wound heals. Doctors may be able to discuss the results with you after the study or you may have to wait a bit longer. 

When would I need a cerebral angiogram? 

Doctors use cerebral angiograms to detect or confirm abnormalities that may be present in the brain. These include aneurysms, brain tumour, blood clot, stroke, and vasculitis. 

You might need a cerebral angiogram in preparation for a surgery (e.g. surgical removal of tumour), treatments of vessel abnormalities, or to provide additional information on abnormalities seen in a CT (computerized tomography) or MRI (magnetic resonance imaging) scan. 

Other times, a cerebral angiogram may be used to diagnose the cause for symptoms like slurred speech, double or blurry vision, loss of balance, weakness, and numbness. 

What are some risks/side effects?

As with any medical procedure there are always some risks involved. However, your doctor would have ensured that you are medically fit to undergo this procedure beforehand. Your doctor would have requested this procedure be carried out as there is no other alternative to obtain the information needed. 

Whenever a catheter is inserted into the blood vessel there is an extremely small possibility of a stroke, damage of arteries during the procedure, or formation of clots around the catheter which can also cause a stroke. However, this is really very rare. There is a chance that bruises may form if there is bleeding under the skin. 

Fortunately, advances have been made to contrast dye and toxicity and allergic complications have been reduced. However, there is still a chance of a life-threatening allergic reaction. It is important to inform your doctor if you have had a previous contrast allergy or if you are allergic to iodine/shellfish. These types of allergies can be treated with steroids and antihistamines. 

References
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Cerebral Arteriogram. (n.d.). Www.Hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cerebral-arteriogram

Cerebral (Brain) Angiogram | Radiology. (n.d.). Med.Nyu.Edu. https://med.nyu.edu/radiology/about-us/subspecialties/neuro-interventional/our-services/patient-information-brain-angiogram