Understand the problem before choosing treatment

Cerebral angiography

A catheter cerebral angiogram provides detailed images of the arteries and veins in the head and neck. It can help evaluate aneurysms, arteriovenous malformations or fistulas, narrowing, and other vascular disorders when the additional detail will guide care.

A catheter is introduced through an access artery, often at the wrist or groin, and advanced under X-ray guidance. Contrast is injected while images are acquired. Local anesthetic and the sedation or anesthesia plan are tailored to the patient and procedure.

Timing and observation vary. The visit includes preparation and recovery as well as imaging; it should not be assumed to be a 15-minute visit. The team will explain risks, including access-site bleeding, contrast reactions, kidney-related concerns, vessel injury, and stroke.

At our ambulatory surgical facility, recovery after a diagnostic cerebral angiogram typically takes 1–2 hours, followed by same-day discharge when the care team clears you. There are no overnight facility stays. Arrange a responsible adult to drive you home.

The right image for the right question

These tests answer different questions. The goal is to obtain the information that changes care while weighing each test’s benefits and risks.

Advanced imaging for a brain AVM

MRI helps define the brain and surrounding tissue; CTA or MRA can show abnormal vessels. A cerebral angiogram can then map feeding arteries, the central vessel tangle, and draining veins, including the order in which they fill. This detail helps a specialist team evaluate observation, embolization, surgery, or radiosurgery.

Learn more: ACR/RSNA stroke imaging · NINDS arteriovenous malformations.

Spinal angiography

Spinal angiography maps arteries and veins supplying the spinal cord. It is especially useful when a spinal vascular malformation or fistula is suspected or when treatment planning requires a detailed vascular map.

Several arteries may need to be studied, so the duration can vary substantially. The catheter access, anesthesia, observation, and discharge plan are individualized. The team discusses neurological and other procedure-specific risks before testing.

How spinal angiography helps diagnose a spinal dural AVF ↗

Wada testing

A Wada test may be used in selected epilepsy-surgery evaluations to help assess language dominance and memory function. A short-acting anesthetic temporarily affects one side of the brain while a specialist team performs structured testing.

Angiographic assessment helps the team understand the circulation before testing. The epilepsy and neuropsychology teams determine whether Wada testing or another assessment will best answer the surgical planning question.

Inferior petrosal sinus sampling

Inferior petrosal sinus sampling can help distinguish a pituitary source of excess ACTH from a source elsewhere in the body in selected patients with confirmed ACTH-dependent Cushing’s syndrome. It is a specialized diagnostic test, not a treatment for the hormone excess.

Catheters are positioned in veins draining the pituitary. ACTH levels from these sites are compared with peripheral blood samples, sometimes before and after a stimulating medication. Endocrinology and the procedural team interpret the results together with hormone testing and imaging.

The test’s main purpose is identifying the source of ACTH; it does not reliably pinpoint the exact location of a tiny tumor on its own.

Venous imaging & pressure assessment

In selected people with idiopathic intracranial hypertension (IIH), MR or CT venography evaluates the veins that drain the brain. A specialist may recommend catheter venography with pressure measurements, called venous manometry, to assess a narrowing before considering a venous sinus stent.

This is a different evaluation from an arterial cerebral angiogram. A narrow sinus on a scan alone does not establish that a stent is appropriate.

Before and after your test

• Bring relevant imaging, reports, and a current medication list.
• Tell the team about allergies, kidney problems, pregnancy, and prior reactions to contrast or anesthesia.
• Follow the specific instructions provided for fasting, medicines, transport, and recovery.
• Arrange a responsible adult and transportation when instructed, especially if sedation is planned.

Scheduling and the appropriate testing facility depend on the procedure and your clinical needs.