Brain angiogram, also known as a cerebral angiogram, is one of the common diagnostic tests that use X-ray for producing an image to help your doctor find blockages or any other abnormalities existing in the blood vessels, around your head and neck. It’s important to note that blockages or abnormalities might lead to a worse condition such as a stroke or internal bleeding in the brain.
Not everyone who may have arterial blockages needs to have cerebral angiography. It’s usually performed only if your doctor needs more information to plan your treatment after other testing. That’s because it’s invasive and carries some risks
An angiogram can also be used to help treat some of the conditions involving the blood vessels of the neck and brain. Cerebral angiography can help diagnose:
- malformation vasculitis, or inflammation of the blood vessels
- brain tumors
- blood clots
- tears in the lining of an artery
Cerebral angiography may also help your doctor figure out the cause of certain symptoms, including:
- severe headaches
- loss of memory
- slurred speech
- blurred or double vision
- weakness or numbness
- loss of balance or coordination
What happens before the test?
A doctor will ask you about your medical history and any medication you are taking, and will explain the test to you. They will ask you for your consent for the test. If you are too unwell to give your consent, the procedure will be discussed with your family.
You will probably be asked not to eat or drink for four to six hours before the test.
What happens during the test?
The test is carried out in the radiology department in a room with large, high-tech computerised equipment.
There will usually be at least three people in the room with you during the procedure
- a radiologist (the doctor who performs the angiogram and who is trained in reading X-rays and advising on treatment)
- a radiographer (a specialist in taking X-rays and other medical scans)
- a nurse
You will be asked to lie on an X-ray table in the room. The doctor or nurse will put sterile towels over you and clean an area of your groin.
The radiologist will give you an injection of local anaesthetic to numb your groin so you will not be able to feel what is going on. The radiologist will then put a very small tube, called a ‘catheter’, into the main blood vessel in your groin (the femoral artery). The catheter is guided through other blood vessels in your body until it reaches the blood vessels in your neck that supply the brain. You will not feel it moving inside you.
When the catheter is in the right position, the radiologist will inject a special dye through it (called contrast agent), and some X-ray images will be taken. Blood vessels don’t normally show up on X-rays, but this dye makes them visible. Before taking the first picture, the radiographer will move the X-ray equipment into the correct position.
The radiologist will reposition the catheter in different blood vessels in the neck, and take more sets of X-rays with further injections of dye. The injections may give you a general warm feeling, but this goes away quickly.
It is very important that you remain still throughout the procedure to ensure the pictures taken are as clear as possible. The whole procedure is likely to take at least one hour.
Risks of a Cerebral Angiogram
There are extra risks that accompany cerebral angiography since it involves radiation, including:
- Side effects of radiation exposure if you have a history of X-rays and CT scans
- Exposure to radiation while pregnant can lead to birth defects
- Allergic reaction to the contrast dye used for the test
- Complications caused by conditions or medications that affect blood-thinning or clotting