(Cerebral Angiography, Cerebral Angiogram)

Procedure Description

What is a cerebral arteriogram?

An arteriogram, also called an angiogram, is an x-ray image of the blood vessels. It is performed to evaluate various vascular conditions, such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages.

A cerebral arteriogram is an arteriogram of the blood vessels of the brain.

How is an arteriogram performed?

In order to obtain an x-ray image of a blood vessel, an intravenous (IV) access is necessary so that a contrast dye can be injected into the body's circulatory system. This contrast dye causes the blood vessels to appear opaque on the x-ray image. This allows the physician to better visualize the structure of the vessel(s) under examination.

Many arteries can be examined by an arteriogram, including the arterial systems of the legs, kidneys, brain, and heart.

For a cerebral arteriogram, IV access may be obtained through the carotid artery in the neck, the femoral artery in the groin, or, less frequently, the brachial artery in the elbow area of the arm. The femoral artery is most commonly used because it allows visualization of the carotid and cerebral arteries. Once IV access is obtained, the contrast dye is injected, and a series of x-ray pictures is made. These x-ray images show the arterial, venous, and capillary blood vessel structures and blood flow in the brain.

Other related procedures that may be used to diagnose brain disorders include x-rays, magnetic resonance imaging (MRI) of the brain, and computed tomography (CT scan) of the brain. Please see these procedures for additional information.

Reasons for the Procedure

A cerebral arteriogram may be performed to detect abnormalities of the blood vessels within or leading to the brain. Such abnormalities include aneurysms, stenosis, arteriovenous malformation (a condition in which there is an abnormal connection between the arteries and veins), thrombosis (a blood clot within a blood vessel), or occlusion (narrowing of a blood vessel).

A cerebral arteriogram may be performed to locate clips on blood vessels placed during previous surgical procedures, and/or to evaluate the condition of such clipped vessels after a clipping procedure.

A cerebral arteriogram may be recommended after a previous test, such as a CT scan, indicates the need for further information that may be obtained by this procedure.

There may be other reasons for your physician to recommend a cerebral arteriogram.

Risks of the Procedure

The amount of radiation used during a cerebral arteriogram is considered minimal; therefore, the risk for radiation exposure is very low.

If you are pregnant or suspect that you may be pregnant, you should notify your physician. Radiation exposure during pregnancy may lead to birth defects. If it is necessary for you to have a cerebral arteriogram, special precautions will be made to minimize the radiation exposure to the fetus.

There is a risk for allergic reaction to the dye. Patients who are allergic to or sensitive to medications, contrast dye, iodine, or shellfish should notify their physician. Also, patients with kidney failure or other kidney problems should notify their physician.

Patients with liver or thyroid conditions should notify their physicians. In some cases, this procedure is not advised for patients with these conditions.

Notify your physician if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

Because the procedure involves the blood vessels and blood flow of the brain, there is a small risk for complications involving the brain. These complications may include, but are not limited to, the following:

• loss of consciousness
• transient ischemic attack (TIA, a brief stroke-like condition)
• hemiplegia (paralysis of one side of the body)
• embolus (clot in the blood vessel)
• hemorrhage (bleeding)
• hematoma (an area of swelling caused by a collection of blood)
• cerebrovascular accident (stroke)
• aphasia (loss of the ability to speak or the ability to understand speech)

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Patient Preparation

• Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
• You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
• Generally, no prior preparation, such as fasting or sedation, is required.
• Your physician may give you specific instructions about smoking and consuming caffeine. You may be asked to refrain from smoking for at least two hours before the test, as smoking causes blood vessels to constrict. You may also be asked to refrain from consuming caffeine in any form for about two hours prior to the test.
• Based on your medical condition, your physician may request other specific preparation.

A carotid artery doppler scan may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, a cerebral angiogram follows this process:

• You will be asked to remove any clothing, jewelry, or other objects that may interfere with the scan.
• If you are asked to remove clothing, you will be given a gown to wear.
• You will lie on an examination table with your neck slightly extended (bent backward).
• A clear gel will be placed on the skin at various locations on the carotid arteries.
• The Doppler transducer will be pressed against the skin and moved around over the area of the artery being studied.
• When blood flow is detected, you will hear a "whoosh, whoosh" sound. The probe will be moved around to compare blood flow in different areas of the artery. Both sides of the neck will be examined.
• Once the procedure has been completed, the gel will be wiped off.

The technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort.

While the cerebral angiogram procedure itself causes no pain, having to lie still for the length of the procedure might cause slight discomfort.

There is no special type of care required after a carotid artery doppler scan. You may resume your usual diet and activities unless your physician advises you differently.

Frequently Asked Questions about Cerebral Angiograms

Q. Does the test hurt?

A. Generally, there is little or no discomfort during the procedure.

Q. How long does the test take?

A. The itself may take anywhere from 20 to 45 minutes.

Q. What is the test looking for?

A. See prior discussion above.

Useful Links About This Procedure

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.

This page contains links to other Web sites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these Web sites, nor do these sites endorse the information contained here.

Alzheimer's Association

American Academy of Orthopaedic Surgeons

American Academy of Neurology

American Cancer Society

American Heart Association

American Stroke Association

Brain Injury Association

Epilepsy Foundation of America

National Cancer Institute

National Institute for Neurological Disorders and Stroke

National Institutes of Health (NIH)

National Library of Medicine