CEREBRAL ANGIO

Question 1

is the radiologic and angiographic examination of the blood vessels of the brain

Answer 1

cerebral angiography

Question 2

who introduced cerebral angio and when was it introduced

Answer 2

Egas Moniz, 1927

Question 3

Accdg. to Egaz, what was the transit time of the cerebral circulation?

Answer 3

3 secs

Question 4

Accdg to Greitz, what was the circulation time?

Answer 4

4.13 secs

Question 5

5 clinical indication of cerebral angio

Answer 5

1. Intracerebral and subarachnoid hemorrhage
2. Aneurysms presenting as space occupying lesions
3. Brain arteriovenous shunts, carotico-cavernous fistulas (direct and indirect)
4. Cerebral ischemia both of extracranial and intracranial origin
5. Pre-operative assessment of intracranial tumours.

Question 6

5 contraindications of cerebral angio

Answer 6

1. Patients with unstable neurology (usually following
   subarachnoid hemorrhage or stroke)
2. Patients unsuitable for surgery
3. Patients in whom vascular access would be impossible or
   relatively risky
4. Iodine allergy. Relative contraindication as angiography could
   be performed with gadolinium chelates.

Question 7

Approach of cerebral angio

Answer 7

transfemoral approach

Question 8

Aside from a trans-femoral approach, what other approaches can be done in cerebral angio?

Answer 8

brachial or axillary artery approach

Question 9

Equipment used in cerebral angio

Answer 9

Bi-plane imaging DSA
3d rotational angiography

Question 10

A single or biplane digital subtraction angiography apparatus is required, with a C-arm allowing unlimited imaging planes, high quality fluoroscopy, and road-mapping facility

Answer 10

Bi-plane imaging DSA

Question 11

Three-dimensional rotational
angiography is now increasingly
available and forms an important part of the analysis of aneurysms during treatment

Answer 11

3D Rotational Angiography

Question 12

Contrast media used in cerebral angiography

Answer 12

Non-ionic monomer, e.g. iohexol, iopamidol. 150 g Iml -1

Question 13

Procedure of Cerebal angio

Answer 13

1. Sedate patient w/ local anesthetic
2. with a small needle, gain access in the femoral artery in the groin w/ ultrasound guidance
3. replace small needle with a small plastic tube w/c acts as an entry point for the catheter
4. catheter is carefully maneuvered through the aorta and into the desired neck arteries
5. the patient is asked to hold their breaths while contrast dye is injected
6. Angiography produces a video or
   sequence of pictures as the dye moves through the blood vessels in the brain

Question 14

Complications of cerebral angio

Answer 14

• Allergic reaction to the contrast dye
• Blood clot or bleeding where the catheter is inserted, which could partly block blood flow to the leg
• Damage to an artery or artery wall from the catheter, which can block blood flow and cause a stroke (rare)
• Damage to the kidneys from the IV contrast

Question 15

Positioning of head

Answer 15

ap and lateral (supine)

Question 16

Aftercare of cerebral angio

Answer 16

1. Standard nursing care for the arterial puncture site
2. Most departments adopt the practice of maintaining neurological observation for a period of 4 h or so after the procedure
3. Good hydration should be maintained.