Diagnostic Gold Standard for Blood Vessels of Head, Neck, and Spine

Cerebral Angiography: The "Gold Standard" For Investigating Cerebral Vessel Disorders

A cerebral angiography is a diagnostic test that uses an X-ray. The test produces a cerebral angiogram – or image – that a doctor can use to find blockages or other abnormalities in the blood vessels of the head or neck. This test is important for detecting abnormalities that could lead to a stroke or cerebral hemorrhaging. To conduct a cerebral angiography, the doctor injects a contrast medium into the blood. This contrast material helps the X-ray create a clear picture of the blood vessels so that any blockages or abnormalities can be identified.

Not everyone who has arterial blockages needs to have a cerebral angiography. This test is only performed when the doctor needs more information or to plan treatment after other testing. Cerebral angiography can be used to help diagnose an aneurysm, arteriosclerosis, arteriovenous malformation, vasculitis, brain tumors, blood clots, or tears in the lining of an artery. This test can also help doctors determine the cause of certain symptoms including stroke, severe headaches, loss of memory, slurred speech, dizziness, blurred or double vision, weakness or numbness, or loss of balance or coordination.

Spinal Angiography: The "Gold Standard" For Investigating Spinal Vessel Concerns

Spinal angiography is a procedure that is used to acquire extremely detailed images of spinal vessels. To conduct this procedure, a contrast medium is injected through a catheter, and the catheter is inserted into the groin and carefully advanced into the targeted blood vessel using the guidance of low-dose x-rays. The contrast medium allows the vessels of the spinal cord and surrounding tissues to be seen in extreme detail, and blood flow from the arteries to the veins can be viewed in sequence.

A spinal angiography is used to help diagnose medical conditions involving the arteries and veins of the spinal cord. This may include spinal cord vascular malformations, certain types of spinal cord stroke, and disorders involving the spinal cord venous system.

Minimally Invasive Diagnosis And Treatment Of Blood Vessel Disorders Of The Head, Neck And Spine

Blood vessel disorders of the head, neck, and spine, can be diagnosed and treated using minimally invasive techniques. Simple, painless tests using ultrasound can determine the presence, location, and severity of vascular disorders. These techniques have fewer risks and offer shorter recovery times.

Minimally invasive treatment options for blood vessel disorders of the head, neck, and spine are also available. Endovascular surgery utilizes catheters to access arteries and veins, allowing doctors to treat a variety of vascular conditions. These procedures are less invasive, with no incisions, a shorter hospital stay, less pain, lower risk of complications, and a shorter recovery time.

WADA Testing: For Pre-Surgical Evaluation

The intracarotid sodium amobarbital procedure, or ISAP, is more commonly known as the Wada test. The name stems from Dr. Juhn Wada, the first doctor to perform this procedure. This test is used by epilepsy doctors to determine where the focus of a seizure is located and whether it can be safely removed via surgery. Adults and children are eligible to undergo the Wada test as needed.

During the anigraphy, which is the first step, X-ray dye is injected through a small tube and images are taken as the dye flows through the arteries. Following this, one side of the brain is put to sleep for about 10 to 15 minutes and then the other side of the brain is tested for language, memory, and other functions. This determines which side of the brain is the dominant side for these respective functions.

When the test concludes, the results are evaluated to determine the next step which could be surgery or additional monitoring. The Wada test is generally safe and poses few risks. Patients are monitored for several hours before being sent home with instructions to avoid heavy lifting and strenuous exercise for a few days.

Balloon Occlusion Testing: For Pre-Surgical Evaluation

The balloon occlusion test is ordered if one of the four main arteries to the brain is compromised, for example by an aneurysm or a tumor. Four main arteries supply blood to the brain. In most individuals, links between these arteries exist so that if one artery is blocked the necessary amount of blood still reaches the brain.

The balloon occlusion test determines whether one artery connected to the brain can be temporarily or permanently blocked without significantly affecting the overall amount of blood that flows to the brain.

When the test begins, a catheter is inserted into the groin area and a special dye is injected. X-rays determine that the catheter is placed correctly and the dye enables detailed images of arteries to be captured. A small balloon is inflated to temporarily block the artery. Monitoring then occurs to observe if blood flow remains sufficient or if brain function is impacted due to insufficient blood flow. The length of the procedure varies from less than an hour to several hours.