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| Cerebral Angiography |
What is Cerebral Angiography?
Cerebral angiography is a medical imaging technique used to visualize the
arteries and veins of the brain and neck. A catheter is inserted into an
artery, usually in the groin area, and threaded up through the blood vessels
until it reaches the brain vessels. Then a special dye, known as a contrast
material, is injected through the catheter and X-rays are taken to see how
blood flows through the blood vessels. This helps doctors diagnose and treat conditions
related to the blood vessels in the brain.
Reasons for Cerebral Angiography
There are several reasons why doctors may recommend a cerebral angiography:
- Aneurysm: Cerebral angiography is often used to detect or monitor brain
aneurysms, which are weak or bulging areas in the artery walls. It can
determine the precise location, size and shape of an aneurysm.
- Arteriovenous Malformation (AVM): An AVM is an abnormal connection between
arteries and veins in the brain without an intervening capillary bed.
Angiography helps map out these tangled vascular structures.
- Stroke: If a person had a stroke but the cause is unclear, angiography can
check for blood clots, narrowing of arteries, etc. that may have led to the
stroke.
- Head/Neck Injury: In cases of traumatic injury to the head or neck region,
angiography allows doctors to evaluate if there is any blood vessel damage or
bleeding.
- Pre-surgical Planning: It is commonly used before surgeries that involve
blood vessels in or around the brain, such as aneurysm repair or AVM removal,
to carefully study the anatomy.
Procedure Details
During Cerebral
Angiography procedure, the patient is given a mild sedative to relax
them. They are also monitored for vital signs like blood pressure, heart rate, breathing
etc. The groin area where the catheter is inserted is cleaned and numbed using
local anesthesia.
Then a thin plastic catheter is fed through an artery, usually the femoral
artery in the groin, and guided up towards the arteries supplying blood to the
brain. Real-time X-ray imaging helps the doctor track the path and position of
the catheter. When it reaches the desired blood vessel, contrast dye is
injected through the catheter and multiple X-ray images are quickly captured.
The process may be repeated to map out vessels from different angles. In some
cases, the catheter can also be used to perform procedures such as aneurysm
coil embolization during the same sitting. The entire procedure takes
approximately 30-90 minutes depending on complexity. Pressure is applied to the
puncture site for 10-30 minutes after catheter removal to prevent bleeding.
Risks and Discomforts
While cerebral angiography is low risk, there are some potential complications
that patients should be aware of:
- Allergic reaction to contrast dye: Severe allergic reactions are rare but
possible.
- Infection: Risk of developing infection at the catheter entry point. Proper
sterile technique is followed to minimize this.
- Bleeding: There is a small chance of bleeding during or after the procedure
where the catheter was inserted. Applying firm pressure counters this.
- Stroke: A stroke can very rarely occur during the procedure due to breakage
of plaque or blood clots dislodging. Precise technique and experience of the
doctor keeps the stroke risk very low at around 0.1%.
- Kidney injury: High risk patients may experience some temporary worsening of
kidney function from the iodinated contrast. Ensuring adequate hydration helps
prevent this.
- Vascular injury: The catheter or guidewire can potentially puncture or tear a
blood vessel being navigated which is again exceptionally rare.
Most patients experience only mild discomfort, headache, nausea or dizziness
from the procedure itself which are usually self-limiting. The benefit of
gaining critical diagnostic information greatly outweighs these minor risks for
appropriate cases. Patients are advised to move slowly after the exam and
resume regular activities the next day.
In summary, cerebral angiography is an invaluable imaging tool that plays an
important role in evaluating and managing various diseases involving the blood
vessels in and around the brain. With modern techniques and equipment, it
provides sharp, multi-dimensional views of even the tiniest brain vasculature.
While not without risks, cerebral angiography remains a relatively safe
procedure when performed by experienced physicians using proper guidelines. The
diagnostic and treatment guidance it offers for many neurological conditions
far outweighs any minor potential complications.
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