Cerebral Angiography
Cerebral angiography is nothing more than a catheterization to study the anatomy and diagnose brain blood vessel abnormalities. It is the “gold standard” test for the study of vascular diseases of the brain (aneurysms, arteriovenous malformations, stroke, vasculitis, etc.)
The main indications for the procedure are the suspicion or diagnosis of:
- Cerebral aneurysms – weakened part of the artery wall, which can easily rupture;
- Cerebral arteriovenous malformations – a congenital defect that is due to an abnormal communication between an artery and a vein, which normally does not occur in our circulation;
- Stenosis of carotid, vertebral or other arteries of the brain;
- Stenosis of the dural sinuses and other brain veins – suspected idiopathic intracranial hypertension;
- Vasculitis – inflammation of blood vessels;
- Bleeding (bleeding) or clots;
- Atherosclerosis – decreased space in blood vessels due to the accumulation of plaques of fat, cholesterol and calcium in their walls.
- Tumors that are hypervascular or that invade the blood vessels of the brain.
- The patient must fast for 6-8 hours before the exam;
- Have recent laboratory tests and previous imaging;
- The presence of a companion is recommended;
- Communicate allergies and medications that you use routinely;
- Answer the angiography investigation questionnaire;
- Groin trichotomy should only be performed from 30 minutes to 2 hours before the exam;
- Cannot be tested in the presence of any infection
- Patients with renal failure or with a single kidney need special and specific care for each case;
- All patients should have routine laboratory testing prior to the examination to assess liver, kidney, and hematologic/coagulogram function.
- History of allergy to medications and/or foods must be reported;
- Report all personal morbid history.
- Rest of approximately 6 hours, in the same hospital where the angiography was performed;
- Avoid walking and standing or sitting for a long time in the first 48 hours after the exam;
- The dressing can be removed at home, the day after the exam, preferably under the shower with running hot water;
- It is not allowed to drive for 1 week and do physical activity with the legs for 2 weeks.
How is cerebral angiography done?
To perform the exam, a local anesthesia is applied in the region where the catheter will be introduced (groin or arm region). The doctor will direct the catheter (a small tube) from the insertion site into the blood vessels in the brain.
After that, with the injection of contrast through the catheter, it is possible to evaluate the entire anatomy of the cerebral blood vessels and define the best treatment for the patient. Light sedation may be performed for patient comfort.
How to prepare for the exam?
To perform the exam it is important to fast for about 8 hours to avoid vomiting, especially if the doctor is going to use a medication to calm down during the exam (sedation).
In addition, in some cases it is necessary to stop taking some medications from 1 to 5 before the procedure, such as anticoagulants and some medications for the treatment of diabetes (eg metformin) and, therefore, it is very important to inform the doctor about the medications that if you are taking.
Is Cerebral Angiography exam dangerous?
It is a safe and common test in the practice of the endovascular neurosurgeon or interventional neuroradiologist. The complication rate in the medical literature is around 1%.
The most common risk of the test is an allergic reaction to the contrast, which is unlikely to occur if the patient has no history of allergy. Also, the doctor usually has medication ready in case this happens.
Bleeding at the catheter insertion site or kidney problems due to contrast may also occur, which is rare in patients with no previous history of kidney disease.
