Cerebral Angiography

How to Prepare for the Test

Before the procedure, your provider will examine you and order blood tests.

Tell the provider if you:

• Have a history of bleeding problems or take medicines that are blood thinners
• Have had an allergic reaction to x-ray contrast dye or any iodine substance
• May be pregnant
• Have kidney function problems

You may be told not to eat or drink anything for 4 to 8 hours before the test.

When you arrive at the testing site, you will be given a hospital gown to wear. You must remove all jewelry.

How the Test will Feel

The x-ray table may feel hard and cold. You may ask for a blanket or pillow.

Some people feel a sting when the numbing medicine (anesthetic) is given. You will feel a brief, sharp pain and pressure as the catheter is moved into the body.

The contrast may cause a warm or burning feeling of the skin of the face or head. This is normal and usually goes away within a few seconds.

You may have slight tenderness and bruising at the site of the injection after the test.

Why the Test is Performed

Cerebral angiography is most often used to identify or confirm problems with the blood vessels in the brain.

Your provider may order this test if you have symptoms or signs of:

• Abnormal blood vessels (vascular malformation)
• Aneurysm
• Narrowing of the arteries in the brain
• Vasculitis

It is sometimes used to:

• Look at blood flow to a tumor
• Evaluate the arteries of the head and neck before surgery
• Find a clot that may have caused a stroke

In some cases, this procedure may be used to get more detailed information after something abnormal has been detected by an MRI or CT scan of the head.

This test may also be done in preparation for medical treatment (interventional radiology procedures) by way of certain blood vessels.

What Abnormal Results Mean

Contrast dye flowing out of the blood vessel may be a sign of bleeding.

Narrowed arteries may suggest:

• Cholesterol deposits
• A spasm of a brain artery
• Inherited disorders

Out of place blood vessels may be due to:

• Brain tumors
• Bleeding within the skull
• Bulging of a blood vessel in the brain (aneurysm)
• Abnormal connection between the arteries and veins in the brain (arteriovenous malformation)

Abnormal results may also be due to:

• Cancer that started in another part of the body and has spread to the brain (metastatic brain tumor)
• Syphilis infection of the brain (neurosyphilis)

Risks

Complications may include:

• Allergic reaction to the contrast dye
• Blood clot or bleeding where the catheter is inserted, which could partly block blood flow to the leg
• Damage to an artery or artery wall from the catheter, which can block blood flow and cause a stroke (rare)
• Damage to the kidneys from the IV contrast

Considerations

Tell your provider right away if you have:

• Weakness in your face muscles
• Numbness in your leg during or after the procedure
• Slurred speech during or after the procedure
• Vision problems during or after the procedure

References

Adamczyk P, Liebeskind DS. Vascular imaging: computed tomographic angiography, magnetic resonance angiography, and ultrasound. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 40.

Chernecky CC, Berger BJ. C. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:266-432.