What is a Brain Angiogram?
A brain angiogram, also known as a cerebral angiogram or cerebral angiography, is a specialized imaging procedure that allows Dr Dorothea to visualize the arteries and veins of the brain. This is achieved by injecting a contrast dye into the bloodstream and capturing specialized X-ray images. The dye highlights the blood vessels, providing detailed imaging that is not possible with standard X-rays.
Unlike other imaging tests, a brain angiogram provides real-time information about the speed and flow of blood through smaller blood vessels. It functions more like a video rather than a static photograph, making it highly effective for diagnosing vascular conditions affecting the brain and spine.
Why is a Brain Angiogram Performed?
A brain angiogram is used to diagnose and evaluate various cerebrovascular conditions, including:
- Pulsatile tinnitus
- Arteriovenous fistulas and other vascular abnormalities (AVFs)
- Brain arteriovenous malformations (AVMs)
- Brain aneurysms
- Carotid artery stenosis other vascular narrowings (carotid dissection)
- Blockages or blood clots, such as cerebral sinus thrombosis
- For treatment planning and pressure measurements
How is a Brain Angiogram Performed?
Preparation
- Patients must fast before the procedure, as sedation and pain medication will be administered for comfort.
- Dr Dorothea and a anesthesiologist will review medical history, current medications, and any allergies to medications or contrast dye.
- An IV line will be placed, and vital signs will be monitored throughout the procedure.
During the Procedure
- Positioning & Monitoring
- The patient is positioned on a narrow X-ray table in a specialized procedure room.
- The room may feel cold, but warming blankets are provided for comfort.
- A “time-out” safety huddle is conducted by the medical team to review patient history and procedural details.
- Artery Access & Catheter Insertion
- Dr Dorothea uses ultrasound guidance to locate an access artery.
- A local anesthetic numbs the insertion area (typically radial artery in the wrist).
- A thin flexible tube is inserted into the artery and carefully guided toward the brain’s blood vessels. The tube remains outside the skull; it does not enter the brain itself.
- In the event brain pressure measurements are needed, a thin flexible wire is inserted in a vein in the upper arm above the elbow. The wire has a fiberoptic sensor for pressure measurement.
- Imaging & Diagnosis
- Contrast dye is injected through the thin tube, and real-time X-ray images are captured on a screen, a little bit like a videogame.
- Dr Dorothea evaluates blood vessels on both sides of the brain, repositioning the tube as needed.
- The entire procedure typically lasts 20-30 minutes, but preparation and recovery time extend the total duration to about one to two hours.
What Happens After the Procedure?
- Patients are monitored for a short period to ensure there are no complications.
- Depending on the access site (wrist, upper arm, groin), there may be specific aftercare instructions to follow.
- Dr Dorothea will review the images and determine the next steps.
A brain angiogram is a diagnostic test, but in some cases, treatment can be performed at the same time. It’s essential to clarify with Dr Dorothea whether your procedure is purely diagnostic or includes treatment.
If you have questions or are scheduled for a brain angiogram, contact Dr Dorothea.
