What is a cerebral arteriogram?
An arteriogram is an X-ray of the blood vessels. When done in the brain, it's called
cerebral arteriogram or cerebral angiogram. It’s used to look for changes in the blood
vessels, such as:
For an arteriogram, your healthcare provider inserts a catheter into a large blood
vessel and injects contrast dye. The contrast dye causes the blood vessels to appear
on the X-ray image. This lets the healthcare provider better see the vessel(s) under
For a cerebral arteriogram, a catheter is usually inserted into an artery in the groin.
Sometimes, a large artery in the arm is used. Rarely, an artery in the neck may need
to be used. The groin artery is most commonly used because it’s easier to get to.
Once the catheter is inserted, the contrast dye is injected. Next, a series of X-rays
are made. These images show the arteries, veins, and capillaries and blood flow in
Why might I need a cerebral arteriogram?
This test may be advised when previous tests don’t give enough information.
A cerebral arteriogram is used to look for changes in the blood vessels within or
leading to the brain. Such as:
Ballooning or bulging of a blood vessel (aneurysm)
Blood vessel narrowing (stenosis)
Narrowing of the arteries (atherosclerosis)
Inflammation of the blood vessels that narrows them (vasculitis)
Abnormal connection between the arteries and veins (arteriovenous malformation)
A blood clot within a blood vessel (thrombosis)
A spasm of the blood vessel causing an irregular narrowing of the vessel (vasospasm)
Complete blockage of a blood vessel
Conditions that cause a displacement of the brain's blood vessels may also be seen.
These conditions include:
Dislocation of the brain tissue, caused by pressure within the brain due to swelling,
bleeding, or other reasons (herniation)
A tear in the wall of an artery
Increased pressure within the brain
Fluid in the brain (hydrocephalus)
A cerebral arteriogram may be used to locate or assess clips on blood vessels placed
during previous surgical procedures.
Your healthcare provider may have other reasons to recommend a cerebral arteriogram.
Talk with your healthcare provider about the reason for your test.
What are the risks of a cerebral arteriogram?
You may want to ask your healthcare provider about the how much radiation is used
during the procedure and the risks related to your situation. It’s a good idea to
keep a record of your history of radiation exposure, such as previous CT scans and
other types of X-rays, so that you can tell your healthcare provider. Risks linked
to radiation exposure may be related to the number of X-rays or treatments over a
Tell your healthcare provider if you are pregnant or think you may be. Radiation exposure
during pregnancy may lead to birth defects. If you need to have a cerebral arteriogram,
special precautions will be taken to reduce the radiation exposure to the fetus.
There is a risk for an allergic reaction to the dye used for this test. Tell your
provider if you are allergic to or sensitive to medicines, contrast dye, shellfish,
or iodine. Also tell your provider if you have kidney failure or other kidney problems.
Tell your healthcare provider if you have a history of bleeding disorders or if you
are taking blood-thinning medicines (anticoagulants), aspirin, or other medicines
that affect blood clotting. You may need to stop these medicines before the procedure.
Because the procedure involves the blood vessels and blood flow of the brain, there
is a small risk for complications involving the brain. These complications may include:
Loss of consciousness
Transient ischemic attack (TIA)
Paralysis on one side of the body (hemiplegia)
Blood clot in the blood vessel (embolus)
Bleeding or bruising at the puncture site
A collection of blood and swelling (hematoma) at the site where the catheter is put
Loss of the ability to speak or understand speech (aphasia)
There may be other risks depending on your specific health condition. Discuss any
concerns with your healthcare provider before the procedure.
How do I get ready for a cerebral arteriogram?
Your healthcare provider will explain the procedure to you and ask if you have questions.
You will be asked to sign a consent form that gives permission to do the procedure.
Read the form carefully and ask questions if anything is not clear.
Tell your healthcare provider, the radiologist, or the technologist if you:
Have ever had a reaction to any contrast dye, or if you are allergic to iodine or
Are sensitive to or are allergic to any medicines, latex, tape, and anesthetic agents
(local and general).
Are pregnant or think you may be.
Have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning)
medicines, aspirin, or other medicines that affect blood clotting. You may need to
stop these medicines before the procedure.
Follow any directions you are given for not eating or drinking before the procedure.
Give your healthcare provider a list of all prescribed and over-the-counter medicines
and all herbs, vitamins, and supplements you are taking.
You may be given a medicine to relax you and make you sleepy before the procedure.
If you will be going home after the procedure, have someone with you to drive you
You may also get anticholinergic medicine. This slows down how much saliva you make.
It also blocks the production of acid in the stomach, and slows down the activities
of the digestive tract. If you get this medicine, you may notice that your mouth feels
Depending on the site used for injection of the contrast dye, the recovery period
may last up to 12 hours. You may need to spend the night in the hospital, if necessary.
Your healthcare provider may request a blood test before the procedure to see how
long it takes your blood to clot. Other blood tests may be done as well.
Your healthcare provider may give you other instructions on what to do before the
What happens during a cerebral arteriogram?
A cerebral arteriogram may be done on an outpatient basis or as part of your stay
in a hospital. Procedures may vary depending on your condition and your healthcare
Generally, a cerebral arteriogram follows this process:
You will be asked to remove any clothing, jewelry, hairpins, dentures, or other objects
that may get in the way of the procedure.
If you are asked to remove clothing, you will be given a gown to wear.
You will be reminded to empty your bladder before starting the procedure, which can
take up to 3 hours.
You will be positioned on the X-ray table.
You will be connected to an electrocardiogram (ECG) monitor that records the electrical
activity of your heart. Your vital signs (heart rate, blood pressure, and breathing
rate) and neurological signs will be watched during the procedure. You will have an
IV (intravenous) line put in to give you the sedative medicine.
The catheter (a thin, soft tube) will be put into an artery in either your neck, arm,
or groin after the skin is cleansed, a local anesthetic (numbing medicine) is injected,
and a small cut (incision) is made.
If the catheter will be put into an artery in your groin or the arm, the radiologist
will check your pulses below the site and mark them with a marker so that the circulation
to the limb below the site can be checked after the procedure. In some cases, the
catheter is put into an artery in your neck. If the neck is used, a pillow will be
placed under your shoulders to keep your neck extended. Your head will be held in
place with a strap or tape to prevent the risk of damage to the artery that might
happen if you move your head. If the groin or arm is used, the site will be shaved
prior to insertion of the catheter.
Once the catheter is put into the artery , it’s threaded through to an artery in the
neck. A special type of X-ray, called fluoroscopy, will be used to verify the location
of the catheter inside your body.
An injection of contrast dye will be given. The contrast dye makes the blood vessels
show up on the X-ray image. This allows the healthcare provider to better see the
structure of the vessel(s).You may feel some effects when the dye is injected into
the catheter. These effects include a flushing sensation, a salty or metallic taste
in your mouth, a brief headache, or nausea or vomiting. These effects usually only
last for a few moments.
You should tell the radiologist right away if you have any breathing difficulties,
sweating, numbness, or heart palpitations.
After the contrast dye is injected, a series of X-rays will be taken. The first series
of X-rays shows the arteries, and the second series shows capillary and vein blood
Depending on the study being done, there may be one or more injections of contrast
When the test is done, the catheter will be removed and pressure will be applied over
the area or a plug-like device will be used to keep the artery from bleeding.
After the site stops bleeding, a dressing will be applied to the site. A sandbag or
other heavy item may be placed over the site to prevent further bleeding or the formation
of a hematoma at the site.
What happens after a cerebral arteriogram?
Depending on which site was used for injection of the contrast dye, you may need to
stay flat in bed in a recovery area for several hours after the procedure. If the
groin or arm site was used, the leg or arm on that side will be kept straight for
up to 12 hours. The healthcare staff may use ice to ease pain and swelling. If the
neck was used, you will be watched for signs of hoarseness, breathing problems, or
pain or trouble swallowing.
A nurse will monitor your vital signs, your neurological signs, and the injection
site while you are in the recovery area.
You may be given pain medicine for pain or discomfort related to the injection site
or pain from having to lie flat and still for a long period.
You will be encouraged to drink water and other fluids to help flush the contrast
dye from your body.
You may go back to your usual diet after the procedure, unless your healthcare provider
tells you otherwise. You may go back to your usual activities about 8 to 12 hours
after the procedure.
When you have completed the recovery period, you may be returned to your hospital
room or discharged to your home. If this procedure was done as an outpatient, plan
to have another person drive you home.
Once home, check the injection site for bleeding. A small bruise is normal, as is
an occasional drop of blood at the site.
If the groin or arm was used, monitor the leg or arm for changes in temperature or
color, pain, numbness, tingling, or loss of function of the limb.
Drink plenty of fluids to prevent dehydration and to help flush out the contrast dye.
You may be advised not to do any strenuous activities or take a hot bath or shower
for a period after the procedure.
When should I call my healthcare provider?
Get prompt medical attention if any of the following happen:
Fever or chills
Increased pain, redness, swelling, bleeding, or other drainage from the injection
Coolness, numbness and/or tingling or other changes in the affected extremity
Speech or vision changes
Muscle weakness or numbness
Your healthcare provider may give you other instructions after the procedure, depending
on your situation.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure