Blood vessel blockages or abnormalities can lead to a stroke or bleeding in the brain. Cerebral angiography is a procedure originally pioneered in 1927 by the Portuguese neurologist Egas Moniz at the University of Lisbon that today uses a catheter, X-ray imaging, and an injection of contrasting material to examine blood vessels in the brain for abnormalities such as aneurysms and disease such as atherosclerosis. The use of a catheter makes it possible to combine diagnosis and treatment in a single procedure. Cerebral angiography produces very detailed, clear, and accurate pictures of blood vessels in the brain and may eliminate the need for surgery.

Doctors use cerebral angiography to detect problems within the blood vessels in the brain, including:

•    aneurysm, a bulge, or sac that develops in an artery due to weakness of the arterial wall.
•    atherosclerosis, a narrowing of the arteries
•    arteriovenous malformation, a tangle of dilated blood vessels that prevents normal blood flow in the brain.
•     vasculitis (inflammation of the blood vessels)
•    brain tumor
•    blood clots
•     vascular dissection (tear in the wall of an artery)
•    stroke

A cerebral angiogram may be performed to:

•    evaluate arteries of the head and neck before surgery
•    provide additional information on abnormalities seen on MRI or CT of the head
•    prepare for medical treatments, such as in the surgical removal of a tumor
•    prepare for minimally invasive treatment of a vessel abnormality

The procedure may also be used to help diagnose the cause of symptoms, including:

•    severe headaches
•     incoherent speech
•    dizziness
•    blurred or double vision
•    weakness or numbness
•    loss of coordination or balance

The cerebral angiogram is considered a minimally invasive procedure. The most serious risk, though very unlikely, is a possibility of a stroke (damage of arteries supplying the brain) during the procedure, or formation of thrombi (clots) around or within the catheter can cause a stroke. Also, during an angiogram procedure, X-rays are used to track the placement of the catheter and to record the flow of blood in the brain. This can lead to exposure to radiation, which would add to an individual’s accumulated lifetime risk.

However, the benefits of cerebral angiography outweigh the risks. While a cerebral angiogram procedure can pose risks such as the ones mentioned before, it also has clear benefits. An angiogram can provide a much more detailed picture of the brain’s vascular system than other kinds of imaging technology such as MRI and CAT scan. This allows doctors to diagnose some conditions that would never be seen with only those types of scans, such as cerebral vasculitis, which affects small arteries.

The cerebral angiogram procedure also allows doctors to observe not only the blood vessels in static form, but also the flow of blood through them in motion. This can help to pinpoint very minute areas of narrowing or leakage that would not be visible with MRI or CAT scans. With the precise and detailed imaging made possible by contrast dyes, a cerebral angiogram procedure can also help with planning cerebral treatments for conditions affecting blood vessels, such as balloon angioplasty or the placement of stents. Depending on a patient’s profile including age, overall health and the condition in question, a cerebral angiogram can be the most effective tool for diagnosing and treating many conditions affecting the brain’s vascular system, particularly those that might be missed using noninvasive scanning procedures, such as MRI or CAT scans. An experienced doctor can work with the patient to determine whether a cerebral angiogram is the best procedure worth considering.

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