What is a cerebral angiogram?

It is a diagnostic procedure which can detect problems within the blood vessels of the brain called cerebral angiogram. This procedure is preformed in an operating room by dedicated health care providers.

Commonly during the procedure, a healthcare provider feeds a thin plastic tube called a catheter through an artery in your wrist or groin. They will then inject a special dye or contrast material through the catheter, which makes your blood vessels more visible. Afterward, the provider takes x-ray pictures of your blood vessels as you lie on the procedure table.

Cerebral angiograms can provide more detailed images of these blood vessels than other imaging test, such as CT (computed tomography) or MRI (magnetic resonance imaging) scans. Cerebral angiograms as they are also known are called digital subtraction angiography of the brain(DSA).

Why would I require a cerebral angiogram?

Other times, cerebral angiograms are just for diagnosis. Other times, they enable caregivers to treat specific conditions.

Caregivers use cerebral angiograms for many reasons. One is to diagnose or establish blood vessel disease in your brain, including:

• Brain aneurysm
• Atherosclerosis
• Arteriovenous malformation
• Dural arteriovenous fistula
• Vasculitis
• Vascular dissection (when the inner lining of an artery ruptures)
• Stroke (blood clot)

Other uses include:

• For comparison of your head and neck arteries before surgery or other medical procedures on your brain, head or neck.
• To observe how blood vessels are attached to or “nourishing” a brain tumor.
• To learn more about abnormalities that the practitioners noticed on other imaging studies, like an MRI or CT scan.

How do I prepare for a cerebral angiogram?

Prior to a cerebral angiogram, your physician will take care to determine that it is safe for you to undergo the test. They might include a physical exam, some laboratory tests, and questioning you about your medical history.

Make sure to let your provider know:

• What medications you take now, including over-the-counter and supplements Any medical conditions and current illnesses.

• If you have bleeding disorders or are on blood-thinning drugs. This includes using painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs).
• If you have allergies, especially if they are to anesthesia, contrast dye or any iodine.
• If you are pregnant or think you might be pregnant.

If a sedative (a medication to keep you relaxed) will be given in the course of procedure, your supplier could let you know not to eat nor drink anything few hours before the test. If you’re going to be lightly sedated or are getting general anesthesia, you’ll also require a buddy to drive you home after the examination.

Either way, you will be advised by your provider how to prepare, for instance, alteration in your routine medication or eating regimen. Make sure you do as told.

What can I expect from a cerebral angiogram?

Usually, the following should be expected when undergoing a cerebral angiogram:

1. You will be put into a medical gown.
2. A radiologic technologist or general nurse will put an IV line into a vein in your arm or hand to administer a sedative, if necessary. This will only be a tiny pinch. General anesthesia is sometimes needed in some patients, most notably adolescents and children.
   3. A nurse or other professional will put sensors on your body to track your heart rate and blood pressure during the test.
   4. You will recline on the exam table.
   5. Someone will strap, tape or use a foam head holder to hold your head in place.
   6. Someone will sterilize the part of your body where they will put in the catheter (a long, thin plastic tube) — commonly in your groin, leg or arm.
   7. Someone will inject a local anesthetic to numb the area. This can sting or burn for a moment before the area numbs.
   8. The provider will insert a small cut in the skin where they will place the catheter.
   9. They will place a catheter into an artery under image guidance through a very small hole that they will puncture using a needle. Pressure will be felt when this is being done, but not pain.
   10. They’ll keep advancing the catheter through your body’s artery to a neck artery. You will not feel them advancing the catheter.
   11. The provider will then inject the contrast material through the catheter. You might feel warmth when the contrast material flows through your body, but it will only be temporary.
   12. When the contrast material reaches the blood vessel(s) that your provider wants to examine, they’ll take several sets of X-rays. You’ll need to stay very still, even holding your breath, during this part so they can get high-quality images.
   13. After taking the proper X-rays, the physician will remove the catheter. They will compress your artery for some time to prevent bleeding into the skin around it (hematomas). They might use a closure device to close the tiny hole in your artery. Your small hole in the skin will be bandaged by a nurse.
   14. A physician will remove your IV line.

How long is a cerebral angiogram?

Generally, a cerebral angiogram will take one to three hours. With the prep time, and aftercare time, expect to spend longer at the hospital.

How long does it take to recover from a cerebral angiogram?

After your cerebral angiogram, you will be in a recovery room for observation for a few hours. After observation, you will be able to go home.

Your physician will have provided you will specific instructions for your care. Follow those instructions.

You may return to your normal eating habits immediately after the exam. As a general rule, you should not return to activities other than eating for eight to twelve hours after completion of the exam.

If you are breastfeeding, you should wait twenty-four hours after the contrast material injection before resuming breastfeeding.

What risks are associated with a cerebral angiogram?

Any procedure that involves placing a catheter inside a blood vessel has certain risks, including:

• Damage to the blood vessel, potentially causing internal bleeding
• Bruising or bleeding at the site of the puncture
• Infection

Additionally, a cerebral angiogram has potential risks, including:

• An allergic reaction to the contrast agent : this is uncommon. If a reaction occurs, your radiologist will intervene properly to treat it.
• Kidney injury due to the contrast agent in a patient with diabetes or kidney insufficiency : In most cases, your kidneys should return to normal function in five to seven days following the procedure.
• Clot formation around the tip of the catheter : this is uncommon. If it occurs, the clot may obstruct a blood vessel, resulting in your physician needing to perform a procedure to reopen the vessel.
• Stroke : a stroke could occur if the catheter were to dislodge plaque in one of your vessels and block blood flow in your brain. However, it is uncommon. Fewer than 1 in 100 patients experience this.
  Your physician will review the risks associated with the procedure prior to the examination. Do not be afraid to bring up any worries or ask any questions.

What are the implications of a cerebral angiogram result?

Healthcare professionals order cerebral angiograms for a spectrum of reasons and depending on the reason for your cerebral angiography, you will see different report results.
In most cases, contrast dye that escapes a blood vessel is a sign of bleeding.

Narrowing or blockages of arteries may go with:

• Cholesterol deposits (plaque).
• Vasospasm (spasm of arteries in the brain).
• Genetic conditions.
• Blood clots causing a stroke.

Abnormal blood vessels may go with:

• Brain tumors
• Bleeding inside your skull
• Aneurysm
• Arteriovenous malformation

Regardless, a radiologist will study the images from the test and create a report detailing the findings. They will send that report to your provider (the healthcare professional who ordered the cerebral angiogram) and your provider will talk with you about the findings.

You may have to have a follow up exam or other tests; your provider will let you know why.

When should I contact my provider?

You should contact your provider immediately if any of the following symptoms occur after your procedure:

• Weakness or numbness in your face muscles, arms or legs
• Slurred speech
• Vision problems
• Signs of infection at the catheter insertion location, such as warmth or redness/discolorization that is too excessive
• Dizziness
• Chest pain
• Trouble breathing
• Skin rash

Is a cerebral angiogram classified as surgery?

A cerebral angiogram is not classified as surgery. A cerebral angiogram is actually a minimally invasive diagnostic procedure.

In the concept of surgery, surgery means the surgeon is changing the body with the division (cut) or destruction of tissues. The cerebral angiogram does have a small cut to insert the catheter, but gamete surgery does not include changing the body’s tissues for surgical purpose.

A note from AyrianaMedTour

Cerebral angiograms are a valuable method for assessing and diagnosing blood vessel conditions in your head. If you require a cerebral angiogram and are feeling anxious about the procedure or have questions about it, reach out to your healthcare provider. They can be a great help and support.