In cerebral angiography, a series of radiographic images of the blood vessels of the head and neck are obtained. The procedure is performed by a neuroradiologist or neurosurgeon. Patients remain awake during the procedure and are given medication to keep them relaxed.
Cerebral angiography is performed by inserting a small flexible catheter (tube) into an artery, usually in the groin. The catheter is guided by fluoroscopy (x-ray video) up through the artery to the large blood vessels leading to the brain (the carotid and vertebral arteries). A contrast agent (dye) is inserted through the catheter into the artery, and radiographic images are taken for 8 to 12 seconds as the contrast circulates through the arteries, capillaries, and veins of the head and neck. The catheter cannot be felt while inside the body. However, as the contrast is inserted, patients may experience a warm flushing sensation for a few seconds, along with a metallic taste in the mouth.
Cerebral angiography can detect abnormal blood circulation to the brain, such as swelling, narrowing of a blood vessel, a clot or obstruction inside a vessel.
Angiography is also used to study blood-vessel displacement caused by tumors, bruising, excess accumulation of fluid, ruptured blood vessels, spasm of blood vessels, increased pressure in the brain, or enlargement of the brain caused by interference with the drainage of cerebral fluid. After an operation, cerebral angiography can help locate clips applied to blood vessels as part of an interventional procedure. It also can be used to visualize blood vessels during endovascular neurosurgery and interventional neuroradiology procedures.
Three-Dimensional Cerebral Angiography
Three-dimensional angiography of a left ophthalmic artery aneurysm.
Three-dimensional angiography is a unique diagnostic and treatment procedure available at a limited number of hospitals across the country. The procedure is the same as cerebral angiography, except that a computerized x-ray process is used to develop three-dimensional images of the blood vessels of the head, neck, or both.
Three-dimensional angiography is used during endovascular neurosurgical treatment of aneurysms and provides several benefits. Instead of seeing a two-dimensional, flat image (like a photograph), the surgeon can view the blood vessel being treated in a more realistic format. Better visualization of the blood vessels allows the surgeon to maneuver more easily, more quickly, and more accurately.
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