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Cerebral Angiography
Frontal View |
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Cerebral
angiography is an invasive test that involves the injection
of contrast media into the carotid artery by means of a
catheter. Radiographs are taken as the dye works its
way through the cerebral circulation. Angiography may
be utilized to identify bleeding aneurysms, vasospasm, and
areriovenous malformations, and to differentiate embolism
from large artery thrombosis [Adams HP, et al, 1994.
Mohr JP, 1992]. Cerebral angiography provides
information on both arteries and veins, with sequential
images showing arterial, capillary, and venous phases.
The
role of conventional angiography in the management of acute
stroke is controversial. The test itself is associated
with a risk of stroke, since the catheter carrying the dye
might dislodge plaque from the carotid wall. In
addition, patients may be allergic to the contrast dye, and
the dye has been associated with the development of renal
failure, particularly when pre-existing kidney disease is
present. Presently, angiography is performed mainly in
selected patients, especially those in whom surgery (such as
carotid endarterectomy or craniotomy for ruptured aneurysms
or arteriovenous malformations) is considered.
Lateral View |
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Conventional angiography has been
replaced by magnetic resonance angiography (MRA) in some patients
with cerebrovascular disease [Bruno A, 1993]. A noninvasive
test, MRA permits the visualization of blood flow in vessels
without the need for catheters or contrast agents. The
technology can yield information regarding collateral blood
flow and is nearly as effective as conventional angiography
in estimating disease at the carotid bifurcation.
This left common carotid angiogram
shows complete occlusion of the left middle cerebral artery
distal to the origin of the anterior temporal branch.
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Stroke Education
