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Cerebral angiography: what is it and what disorders can it detect?

Cerebral angiography: what is it and what disorders can it detect?

December 31, 2022

All our organs require the performance of the cardiovascular system to survive, because thanks to it they receive the oxygen and nutrients necessary for their survival and proper functioning.

This includes our nervous system, which requires a continuous contribution of these elements. But sometimes there may be alterations that damage the vascular system that supplies the brain or symptoms that suggest the existence of such damage.

Therefore it is necessary to have different techniques that allow us to observe and analyze the blood flow of the brain, being one of the best known cerebral angiography .

  • Recommended article: "The 15 most common neurological disorders"

What is a cerebral angiography?

Cerebral angiography is a medical evaluation technique that allows the study and analysis of brain flow and the health of the cerebrovascular system. It is a technique in which X-rays are used to visualize by injecting a contrast into the main cerebral blood vessels the flow and the state of the circulatory system. The images obtained are generally very clear and allow to identify with precision alterations in the blood circulation of the encephalon.


The procedure is as follows: after placing the patient on the X-ray table, the head is immobilized and a sedative is administered while the cardiac activity is monitored. After this, the patient is inserted a catheter in the arteries of the arm or leg, which will be guided by the artery to the neck with the help of X-rays. Once there, a contrast solution is injected through the catheter. to later take images of the blood circulation through radiographs. After that, and unless there is to be some type of intervention through it, the catheter is removed and pressure is applied in the area where it was inserted to prevent bleeding.


Although in general it is used as a technique for the diagnosis and monitoring of cerebrovascular disorders, the fact that a catheter is used to perform it allows, in addition, therapeutic procedures such as drug delivery to be used, thus avoiding need for other treatments.

Types

Cerebral angiography is a technique that has several variants depending on the mechanisms used to assess the state of the patient's blood vessels. Some of the best known are the following .

1. Conventional angiography (by digital intraarterial subtraction)

This is the procedure previously explained, in which the catheter is placed in the artery and guided to its objective. It is an invasive procedure that is usually the most common due to its effectiveness and the high level of clarity it allows. The catheter is usually inserted through the femoral route, through the groin to the aortic arch, where after a first injection of contrast, the catheter is placed in the artery that needs to be analyzed.


With regard to digital subtraction, it refers to the fact that frequently in the radiographs the skull is digitally removed from the image taken, so that the image of the blood vessels can be observed more clearly.

2. Helical computed tomography angiography

In this case, no type of catheter is introduced into the body of the subject, but it requires the injection of a contrast in order to obtain the image by CT. It is less invasive than its conventional counterpart.

3. Magnetic resonance angiography

In this type of angiography, no catheter is used, not being an invasive technique. It involves performing an MRI, not using radiation as in other cases.

What allows to diagnose?

Brain angiography is a test that even today It is used as one of the main ones to observe the circulatory flow and the state of the blood vessels of the brain . There are many disorders and diseases that the application of this technique allows to observe.

1. Stroke or stroke

Angiography allows to observe the existence of extravasation and ruptures of blood vessels, or the absence or obstruction of circulation in some area of ​​the brain. It is because of that this is a valid technique to detect ischemia and to visualize cerebral hemorrhages . (More information about strokes).

2. Aneurysms

The use of angiography allows detecting the presence of aneurysms , bulges of the arterial wall filled with blood and relatively weak wall that can break. (More information on aneurysms).

3. Tumors

The presence of tumors in the brain tends to cause alterations in the blood flow of the brain , as well as cause phenomena such as strokes. Therefore, angiography allows to observe the presence of abnormalities generated by the presence of tumors. (More information on brain tumors).

4. Malformations

The existence of congenital malformations, as occurs in the AVM, can also be assessed by means of this evaluation and diagnostic technique.

5. Arterial or venous alterations

Through brain angiography can be seen if the blood vessels of the brain are in good health, if they are inflamed or if there are disorders such as atherosclerosis.

6. Brain death

Cerebral angiography is also used to evaluate whether or not brain death exists. Specifically, it is evaluated whether or not there is blood flow, observing an absence of irrigation in cases of brain death.

7. Other disorders

There is the possibility of observing, through cerebral angiofraphy, the presence of different disorders and diseases apart from those previously mentioned. For example, alterations can be found in neurosyphilis, or in people with disorders such as Kleine-Levine syndrome.

Risks and possible side effects of this technique

Cerebral angiography is a generally safe technique and does not tend to cause complications , but this does not prevent it from having risks and adverse side effects that can cause alterations of varying severity.

One of the risks is given the possibility that there is allergy to the applied contrast agent in the patient (usually iodized). Also, this could cause discomfort or even destruction of some tissues if extravasated out of the vein. It can also be risky or harmful for people with kidney problems or diabetes.

The existence of symptoms such as tingling, breathing difficulties, vision problems, infection of the route through which the catheter has entered, problems of control of the extremity in which it has been inserted, speech problems or hemiparesis are a sign that There may be some kind of complication to be treated quickly.

Finally, a special precaution is necessary in the case of pregnant or lactating women, since the radiation emitted could be harmful. It can also happen that a tear of the artery that generates some type of hemorrhage or clots that can clog the vessel is caused, although it is something very uncommon.

Bibliographic references:

  • Camargo, M .; Peralta, A .; Arias, W .; Mercado, C .; Laguna, Y .; Cuellar, J .; Laforcada, C .; Paz, G .; Durán, J.C .; Aramayo, M .; Fortún, F. & Núñez, H. (s.f.). Cerebrovascular Accident Protocol. Bolivian Society of Neurology.
  • Millán, J.M. & Campollo, J. (2000). Diagnostic value of cerebral angiography in the confirmation of brain death. Advantages and disadvantages. Med. Intensive, 24 (3); 135-141. Madrid.
  • Daroff, R.B .; Jankovic, J .; Mazziotta, J.C. and Pomeroy S.L. (2016). Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier.

Coronary Angiography | Cardiac Catheterization | Nucleus Health (December 2022).


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