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At least 19 recordsLinked to original sources
PubMed1977

Cerebral angiography in acute cerebral infarction.

Cerebral angiography in the acute phase of clinically diagnosed stroke syndromes was evaluated in a prospective study of 104 consecutive patients over an eight month period at the Massachusetts General Hospital to determine the diagnostic yield. Of 68 patients subsequently documented to have retinal or cerebral hemispheric infarction, 63 (92.6%) had angiographic demonstration of occlusive lesions which appeared to correlate with the clinical deficit. These results are discordant with prior angiographic reports, 2,17,18,20 suggesting that delayed carotid artery angiography fails to show occlusive lesions (embolic) which may be shown acutely.

Acute Disease↗
PubMed1992

The value of cerebral angiography in predicting cerebral ischemia during carotid endarterectomy.

OBJECTIVE: Temporary occlusion of the carotid artery during endarterectomy can result in ipsilateral cerebral ischemia if collateral blood flow is insufficient. This requires placement of a shunt across the carotid bifurcation, which is associated with increased operative risk. We retrospectively analyzed preoperative cerebral angiograms and intraoperative electroencephalographic recordings to determine if ischemia during carotid endarterectomy could be predicted from angiographic data. MATERIALS AND METHODS: The cerebral angiograms of 30 patients were examined. Collateral blood flow to the hemisphere on the side of surgery was determined to be present if both proximal segments of the anterior cerebral artery and the anterior communicating artery were visualized, or if filling and washout of the ipsilateral posterior cerebral artery could be seen. Collateral flow was determined to be inadequate if the anterior collateral system was incomplete, and if either the ipsilateral posterior communicating artery was absent or the posterior cerebral artery filled without washout. This information was compared with intraoperative electroencephalographic and shunting data. RESULTS: Of 15 patients who had demonstrable collateral blood flow, 14 had stable electroencephalograms and did not require a shunt during surgery. In all 15 patients in whom no collateral flow to the ipsilateral hemisphere could be shown, electroencephalographic changes prompted placement of an intraluminal shunt. CONCLUSION: We found that the angiographic determination of inadequate collateral cerebral circulation correlated strongly with the development of intraoperative ischemia. This implies that routine preoperative cerebral angiograms can be used to alert the surgeon to the potential need for shunt placement during carotid endarterectomy.

Aged↗
PubMed1977

Application of longitudinal magnification effect to magnification stereoscopic angiography: a new method of cerebral angiography.

A new method of stereoscopic cerebral angiography has been developed which employs 2X radiographic magnification. In order to obtain the same depth perception in the object as with conventional contact stereoscopic angiography, one can made the x-ray exposures at two focal spot positions which are separated by only 1 inch (2.5 cm), whereas the contact technique requires a separation of 4 inches (10 cm). The smaller distance is possible because, with 2X magnification, the transverse detail in the object is magnified by a factor of two, but the longitudinal detail, which is related to the stereo effect, is magnified by a factor of four, due to the longitudinal magnification effect. The small focal spot separation results in advantages such as improved stereoscopic image detail, better image quality, and low radiation exposure to the patient.

Cerebral Angiography↗
PubMed1992

Comparison of cerebral blood flow by radionuclide cerebral angiography and by microspheres in cats.

BACKGROUND: Radionuclide cerebral angiography is commonly used as an adjunct to the diagnosis of brain death. Despite its acceptance as a diagnostic tool, it is not clear whether the absence of cerebral blood flow by radionuclide cerebral angiography denotes a complete lack of cerebral blood flow. METHODS: To compare cerebral blood flow estimated by radionuclide cerebral angiography with cerebral blood flow measured by the radiolabeled microsphere technique, we systematically varied cerebral perfusion pressure (mean arterial BP minus intracranial pressure) in anesthetized cats by infusing artificial cerebral spinal fluid into the lateral ventricle to increase intracranial pressure. We measured cerebral blood flow with both techniques as cerebral perfusion pressure was decreased from its baseline of 111 +/- 10 mm Hg to 20, 10, 5, 0, and less than 0 mm Hg, causing a stepwise decrease in cerebral blood flow. RESULTS: We found a correlation by regression analysis (r2 = .47, p less than .05) between radionuclide cerebral angiography and microsphere measurements of cerebral blood flow, when both blood flow measurements were expressed as a percentage of baseline values. However, if 20% of baseline flow was assigned as a cut-off point for critically low cerebral blood flow (based on human studies), radionuclide cerebral angiography was only 33% sensitive to detect critically reduced cerebral blood flow and had a positive predictive accuracy (of low-flow interpretation) of only 60%. Radionuclide cerebral angiography was unable to demonstrate a complete lack of cerebral blood flow, even in two instances when cerebral blood flow by microspheres was less than 0.1% of baseline. CONCLUSIONS: We conclude that the ability of radionuclide cerebral angiography to quantify low cerebral blood flow is poor, and that this technique may not identify severely reduced cerebral blood flow.

Animals↗
PubMed1992

Current role of cerebral angiography in the diagnosis of cerebrovascular diseases.

The role of cerebral angiography in the diagnosis of cerebrovascular disease is currently being questioned because of the increasing availability of MR angiography. The purpose of this essay is to place the use of cerebral angiography in perspective in light of these new developments. In patients with atherosclerotic cerebrovascular disease, MR angiography can almost entirely supplant cerebral angiography as a screening procedure in the evaluation of the carotid bifurcation. However, detection of "pseudoocclusion" still requires cerebral angiography for accurate diagnosis. Atherosclerotic stenosis or occlusion of the major intracranial vessels at the base of the brain can be detected with MR angiography, but not as accurately as with cerebral angiography. Furthermore, for detection of more distal occlusions, cerebral angiography is still needed. A number of erroneous concepts about the risks and value of cerebral angiography have prevented its optimal use for patients with cerebrovascular disease. These myths can be countered by applying several rules to optimize the use of cerebral angiography. Subarachnoid hemorrhage is best evaluated with CT followed by detailed cerebral angiography, although MR angiography can be used as a screening test for aneurysms 3 mm or larger. Cerebral angiography is still necessary to confirm the diagnosis of cerebrovascular malformations, although MR angiography is a useful screening test. Cerebral angiography is required for the definitive diagnosis of arteritis, arterial dissection, or fibromuscular dysplasia.

Cerebral Angiography↗
PubMed1979

Possible increased tendency to thrombosis after cerebral angiography.

Two patients are presented in whom cerebral angiography was complicated by bioccipital infarcts resulting in cortical blindness with persisting severe restriction of the visual field (case 1) and persisting cortical blindness (case 2). One patient (case 1) demonstrated a compensated, protracted disseminated intravascular coagulation (Table 1), which disappeared after treatment with phenprocoumon (Marcoumar). The other patient (case 2) demonstrated increasee spontaneous platelet aggregability (Table 2), which was treated sucessfully with acetylsalicylic acid (Magnyl) and dipyridamole (Persantine). We presume that the coagulation disturbances demonstrated after the angiography may be pathogenetic to the complications. We propose that patients with transient cerebral ischemia and apoplexy who are undergoing cerebral angiography should be studied with regard to coagulation before and after the cerebral angiography so that coagulation disturbances demonstrated may be treated before, or corrected after the angiography.

Blindness↗
PubMed1976

Acute renal failure. A complication of cerebral angiography.

Acute renal failure after cerebral angiography is, to our knowledge, previously undescribed, yet well documented after other forms of angiography and intravenous urography. We will describe four patients with this complicaton and discuss factors in its pathogenesis.

Acute Kidney Injury↗
PubMedDate not supplied

Effective dose equivalents to patients undergoing cerebral angiography.

PURPOSE: To determine values of the effective dose equivalent, HE, for patients undergoing diagnostic cerebral angiography and compare these values with radiation doses received by patients undergoing other diagnostic examinations of the head. METHODS: The radiographic techniques for ten patients undergoing cerebral angiography were recorded and used to obtain the product of the entrance skin dose and the x-ray beam cross-sectional area. These measured dose-area product data were converted into effective dose equivalents employing published conversion factors which take into account the part of the patient anatomy irradiated and the radiographic technique factors employed. RESULTS: The average patient HE value was 10.6 mSv, with a range of 2.7-23.4 mSv. Fluoroscopy contributed approximately 67% of the total HE, with cut films and digital subtraction angiography contributing 26% and 7%, respectively. CONCLUSIONS: The radiation doses (HE) to patients undergoing diagnostic cerebral angiography are comparable to the patient doses in nuclear medicine brain studies where the typical HE is approximately 10 mSv. In CT, the patient dose is approximately 2 mSv, whereas in plain skull x-ray examinations, the patient dose is much lower at approximately 0.15 mSv.

Angiography, Digital Subtraction↗
PubMed1975

Femoral percutaneous catheterization in infants and small children for cerebral angiography.

An improved technique of selective cerebral angiography for infants and small chicken is described. The needle is inserted approximately 45 degrees to the skin in order to avoid subintimal placement of the tip. After good backflow is established, the guidewire is advanced to a position in the descending aorta. A No. 3 polyethylene catheter and 21-gauge scalp vein needle were most successful.

Catheterization↗
PubMed1975

[Catheter cerebral angiography in little children. Review of 71 examinations on 59 children under the age of 7 years (author's transl)].

Although the role of the cerebral angiography in the diagnosis of the central nervous system disorders in children is well established, there exists some reluctance to perform angiography in little children, probably due to technical difficulties and possible occurrence of side effects. For the last several years, we have performed catheter cerebral angiography on children with various disorders of central nervous system utilizing Seldinger's transfemoral technique. Our technique has been described in detail with special reference to the dilator catheter and double replacement technique, and the results of 71 catheter angiographies on 59 patients under the age of 7 years have been reviewed. No neurological complication or systemic reaction to contrast medium was noted. Circulatory disturbance at the site of femoral puncture was occasionally noted. Transient circulatory disturbance of several hours' duration was not uncommon in this age group. There were three cases which developed thrombus formation at the puncture site with resultant successful thrombectomy utilizing balloon catheter. The causes of these complications were analysed, and the need for systemic heparinization or heparin coated catheter during catheterization in little children was stressed. Comparison was made with other methods of cerebral angiography applied to children. It has been pointed out that this is a relatively convenient and safe technique applicable to little children, in whom multivessel study is often needed.

Age Factors↗
PubMed1976

Cerebrovasculature permeability changes following experimental cerebral angiography. A light- and electron-microscopic study.

Morphological alterations of the cerebral vasculature as related to the permeability of plasma proteins and angiographic contrast media following unilateral cerebral angiography were studied. Both Evans blue albumin and horseradish peroxidase were employed as protein tracers for light and electron microscopy investigation respectively. Grey matter regions of the cerebral cortex, cerebellum corpus striatum, hippocampus and midbrain showed the most extensive and consistent leakage of these protein tracers. The most extensive penetration of EBA was noted at 1 hr following cerebral angiography as compared to the 5 or 30 min sample times. Permeability changes were noted in small venules and arterioles as well as capillaries. The extent of permeability, however, was appreciably greater in the capillaires as evidences by rapid extravasation of HRP into the surrounding neuropil extracellular spaces. The glial basement membrane surrounding the perivascular spaces of small venules and arterioles precluded rapid penetration of HRP into the neuropil interstitium. Opening of the tight junctions between the endothelial cells was primarily responsible for the extravasation of HRP in all vessel types. Furthermore, it is out opinion that the hyperosmolar nature of the contrast medium is responsible for opening of these tight junctions.

Animals↗
PubMed1975

A new method of autotomography with cerebral angiography (angioautotomography).

A new method of autotomography for cerebral angiography, accomplished by means of a simple and handy device, has made it possible to take arbitrary tomographic planes of angiograms which result in clear cut views of the tomogram. The principle of the device is described, the method of use explained and representative films, produced by this new method, are demonstrated.

Brain Neoplasms↗