Cerebral angiography or
arteriography is a form of
medical imaging that visualizes the
arterial and
venous supply of the
brain. It was pioneered by Dr.
Egas Moniz in 1927, and is now the
gold standard for detecting vascular problems of the brain.
Method
Any form of
angiography involves the passing of a
catheter into a large artery (e.g. the
femoral artery) and advancing this catheter through the
carotid artery. When this has been achieved, a
contrast agent that is relatively impervious to the passage of
x-ray photons is injected, and a rapid series of radiographs is taken while this radiopaque fluid passes through the vasculature. Another series, taken when the contrast agent has passed through the tissues, visualizes the venous supply. Using modern equipment, this method offers better visual representation of cerebral blood vessels than less invasive methods such as
computed tomography angiography and
magnetic resonance angiography.
Uses
Most vascular abnormalities of the brain, e.g.
arteriovenous malformations and
aneurysms, can be detected on cerebral angiography.
In some countries, cerebral angiography is required to confirm brain death.
Interventions
One of the advantages of angiography over alternative techniques (e.g.
magnetic resonance angiography/MRA) is the possibility of performing interventions. Aneurysms, in particular, may be amenable to the angiographic insertion of metal coils, which lead to
connective tissue formation and the obliteration of the aneurysm.
