Cerebral angiography
Alternative names:
angiography of the head; carotid angiogram; vertebral angiogram
How the test is performed:
This test is done in the hospital. You will be asked to lie on the X-ray table. Your head is positioned and immobilized by using a strap, tape, or sandbags. Electrocardiogram (ECG) leads are taped to your arms and legs to monitor your heart during the test. An ECG is a procedure in which patches (electrodes) are put on the body surface to trace the electrical impulses of the heart. The area where the contrast medium will be introduced is shaved and cleansed. The site is usually in the leg. You are given a local anesthetic, the artery is punctured, and a needle is inserted into the artery.
The catheter (a long, narrow, flexible tube) is inserted through the needle and into the artery. It is then threaded through the main vessels of the abdomen and chest until it is properly placed in the arteries of the neck. This procedure is monitored by a fluoroscope (a special X-ray that projects the images on a TV monitor). The contrast medium is then injected into the neck area through the catheter, and the X-ray pictures are taken. The catheter is kept open by flushing it periodically with a saline solution containing heparin, which will keep the blood in the catheter from clotting. Your pulse, blood pressure, and breathing are monitored during the procedure.
After the X-rays are taken, the needle and catheter are withdrawn. Pressure is immediately applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding. After that time, the area is checked and a tight bandage is applied. Your leg should be kept straight for 12 hours after the procedure.
How to prepare for the test:
- Advise the health care provider if you are pregnant or if you have ever had any bleeding problems. Allergic reactions to X-ray contrast material or any iodine substance and any other allergic reactions should be mentioned.
- You must sign a consent form.
- Routine blood tests will be done and an examination of the nervous system performed before the procedure.
- Food or fluid may be restricted 4 to 8 hours before the procedure.
- You will be given a hospital gown to wear. You must remove all jewelry.
- A sedative or pain pill may be given to you before the procedure.
Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
The X-ray table is hard and cold, but you may ask for a blanket or pillow. There is a sting when the anesthetic is given. This does not numb the artery, so there will be brief, sharp pain as the catheter is inserted. There is a feeling of pressure as the catheter is advanced.
As the dye is injected, there is a burning sensation. You may experience a headache or feel flushed on the side of the face. There is tenderness and bruising at the site of the injection after the test.
Why the test is performed:
The test is most frequently used to confirm cases of stroke, tumor, bulging of the artery walls, a clot, a narrowing of the arteries, and to evaluate the arteries of the head and neck before a corrective surgery. It is used to get more exact information after something abnormal has been detected by a CT scan of the head or brain.
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