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CEREBRAL ANGIOGRAMS (ANGIOGRAPHY)

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Definition 

Cerebral Angiography is an x-ray procedure used to visualize the blood vessels of the neck, head and brain (cerebral = head, angio = blood vessel, graphy = picture). It involves the insertion of a tube or catheter into the arteries, usually in the groin, which is then advanced upwards into the arteries of the neck, after which an inert fluid (dye or contrast material) is injected. The dye can be seen on x-rays outlining the inside of the blood vessels. Depending on the number of blood vessels examined it may take from 30 minutes to 2 hours to do.

What is it used for? 

This test may be used for evaluating any disease which effects the blood vessels of the head, neck or brain. Most commonly it is used to look for narrowing of the blood vessels in the neck that can be associated with a risk of stroke, or in looking for weak points in the vessels that might cause hemorrhage.

Preparation 

Since the test involves insertion of a catheter in the groin, you should bath of shower the evening before or morning of testing to ensure your skin is clean (the area will be further cleaned with antiseptic solution at the time of the test). Some medications need to be withheld before the examination because they may interact with the dye. Make sure your doctor is aware of all the medications that you take and ask for instructions from them or the radiology (X-ray) department. Usually, if the test is to be done in the morning before noon you should fast after midnight. If it is to be done in the afternoon, a light breakfast is usually allowed. Consult the radiology department you will be attending for specific instructions. Make sure that you tell the attending radiologist (x-ray doctor), nurse or X-ray technologist if you have any history of asthma, allergies, diabetes mellitus, or are taking any medications, especially Glucophage (Metformin).

Are there side effects? 

One or both of your groin areas will be shaved. There may be some discomfort when the freezing is injected to numb the area in the groin, but the remainder of the test is usually painless. Injection of the dye may be associated with a warm feeling in the head or a metallic taste in the mouth. Rarely people note flashes of light in their vision. The risks of any serious side effect are low, about 0.1%. Serious side effects can include allergic reaction to the dye, bleeding or hematoma at the catheter insertion site or even stroke. Bleeding at the insertion site is avoided by firm compression of the site for 15 minutes, application of a tight pressure bandage for several hours, lying with the hip and leg straight for about 6 hours and staying mostly in bed for about 24 hours.

Where are they done? 

All cerebral angiograms in BC are done in hospital in specially equipped X-ray laboratories by physicians, usually radiologists. Not all hospitals have this capability.

Dr. R. O'Brien