cerebral_angiography

Cerebral angiography

Cerebral angiography is generally recommended in patients with subarachnoid hemorrhage (SAH) by positive lumbar puncture (LP) but negative findings on computed tomography (CT).

The diagnostic yield of cerebral angiography is high (45.7%) in patients with CT-/LP+ SAH. Higher red blood cell counts were noted in patients with cerebral aneurysms but no clinical or laboratory parameter can reliably predict the presence of a vascular anomaly. Thus, it is reasonable to perform cerebral angiography in all patients with CT-/LP+ SAH 1).


In the era before computerized tomography (CT), extradural hematomas were usually diagnosed by invasive and less accurate techniques, such as cerebral angiography, pneumoencephalography, or exploratory burr holes.

The major risk of selective cerebral angiography is transient or permanent neurologic deficit resulting from improper technique, catheter manipulation, or contrast medium infusion. In addition, selective injections of hyperosmotic contrast materials into the common and external carotid arteries may cause pain, resulting in patient movement, decreased image quality, and increased patient discomfort. It is also well established that hyperosmotic contrast media injected into the vertebral or carotid arteries may produce transient disruption of the blood-brain barrier (BBB) with associated neurologic deficit or seizure.

In an effort to further decrease the incidence of patient discomfort and neurotoxicity associated with the ionic contrast agents currently used for cerebral angiography , a number of new, hydrosoluble, nonionic contrast media have been developed

Iopamidol

Methylglucamine iothalamate


1)
Chalouhi N, Witte S, Penn DL, Soni P, Starke RM, Jabbour P, Gonzalez LF, Dumont AS, Rosenwasser R, Tjoumakaris S. Diagnostic yield of cerebral angiography in patients with computed tomography-negative, lumbar puncture-positive subarachnoid hemorrhage. Neurosurgery. 2013 Aug;73(2):282-7; discussion 287-8. doi: 10.1227/01.neu.0000430291.31422.dd. PubMed PMID: 23615086.
  • cerebral_angiography.txt
  • Last modified: 2022/03/22 12:45
  • by administrador