What is cerebral angiography?

Cerebral angiography is used to image the blood vessels of the brain and the blood flowing through them. Angiography involves entering a catheter into the body to inject a dye (a contrast medium) into the carotid arteries, the vessels of the neck that lead to the brain. Then regular x-ray is used to image the dye that is flowing through the blood vessels. Although cerebral angiography can be used to investigate many abnormalities, only its relevance to stroke is discussed here.

Doctors use cerebral angiography to detect abnormalities in the brain’s blood vessels, such as narrowing or blockage. It is usually done after another test (such as a CT scan) has already detected an abnormality. Angiography is useful in detecting and diagnosing acute stroke and is especially beneficial since the images taken through cerebral angiography cannot be taken through other techniques.

The basic principle behind cerebral angiography is the same as that of regular x-ray imaging. As the x-rays pass through the body, they are absorbed at different levels. The absorption of the x-rays by the injected dye allows the blood vessels in the brain to be imaged. The differences in absorption become one of many images detected by a camera, which finally become a “movie” of the blood flow (and the flow of the intravenous dye) through the vessels.

What can I expect during this procedure?

While you are lying on an x-ray table, a local anesthetic is given, usually in the thigh, where an incision is made. The catheter (a long, narrow flexible tube) is put into your body through the incision navigated to the carotid arteries, where the dye is injected. After you are properly placed on the exam table, your head is positioned in the desired field of view, and regular x-ray is used to take pictures of the blood vessels in the brain. Although you are awake during the procedure, a medication may be given to help you relax. The entire procedure can take from one to two hours to complete.

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