Cerebral Arteriogram

By Sara M. Foster, RN, MPH

(Cerebral Angiography, Cerebral Angiogram)

Procedure overview

What is a cerebral arteriogram?

An arteriogram, also called an angiogram, is an X-ray image of the blood vessels. It is performed to evaluate various vascular conditions, such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages.

A cerebral arteriogram is an arteriogram of the blood vessels of the brain.

How is an arteriogram performed?

An arteriogram involves inserting an arterial catheter (a long thin tube) into a large blood vessel and injecting contrast dye. This contrast dye causes the blood vessels to appear opaque on the X-ray image. This allows the doctor to better visualize the structure of the vessel(s) under examination.

Many arteries can be examined by an arteriogram, including the arterial systems of the legs, kidneys, brain, and heart.

For a cerebral arteriogram, arterial access is usually obtained in the femoral artery in the groin. Occasionally, the brachial artery in the arm may be used, and, in very rare instances, the carotid artery in the neck may need to be used. The femoral artery is most commonly used because it is generally easier to access. Once the catheter is inserted, the contrast dye is injected, and a series of X-ray pictures is made. These X-ray images show the arterial, venous, and capillary blood vessel structures and blood flow in the brain.

Other related procedures that may be used to diagnose brain disorders include X-rays, magnetic resonance imaging (MRI) of the brain, and computed tomography (CT scan) of the brain. Please see these procedures for additional information.

Reasons for the procedure

A cerebral arteriogram may be performed to detect abnormalities of the blood vessels within or leading to the brain. Such abnormalities include aneurysms, stenosis, arteriovenous malformation (a condition in which there is an abnormal connection between the arteries and veins), thrombosis (a blood clot within a blood vessel), vasospasm (a spasm of the blood vessel causing an irregular narrowing of the vessel), or occlusion (complete obstruction of a blood vessel).

Other conditions that cause a displacement of the brain's blood vessels may be detected by a cerebral arteriogram. These conditions include tumors, edema (swelling), herniation (dislocation of the brain tissue, caused by pressure within the brain due to swelling, bleeding, or other reasons), increased intracranial pressure (ICP, or increased pressure within the brain), and hydrocephalus (fluid in the brain).

A cerebral arteriogram may be performed to locate clips on blood vessels placed during previous surgical procedures, and/or to evaluate the condition of such clipped vessels after a clipping procedure.

A cerebral arteriogram may be recommended after a previous test, such as a CT scan, indicates the need for further information that may be obtained by this procedure.

There may be other reasons for your doctor to recommend a cerebral arteriogram.

Risks of the procedure

You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.

If you are pregnant or suspect that you may be pregnant, you should notify your health care provider. Radiation exposure during pregnancy may lead to birth defects. If it is necessary for you to have a cerebral arteriogram, special precautions will be made to minimize the radiation exposure to the fetus.

There is a risk for allergic reaction to the dye. Patients who are allergic to or sensitive to medications, contrast dye, or iodine should notify their doctor. Also, patients with kidney failure or other kidney problems should notify their doctor.