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Chapter 11 - Cerebral angiography

Published online by Cambridge University Press:  04 May 2010

J. Ricardo Carhuapoma
Affiliation:
Johns Hopkins Hospital, Baltimore
Stephan A. Mayer
Affiliation:
Columbia University, New York
Daniel F. Hanley
Affiliation:
Johns Hopkins Hospital, Baltimore
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Summary

Patients presenting with acute onset of focal neurological deficits must be evaluated for intracerebral hemorrhage (ICH). Digital subtraction angiography (DSA) is the most definitive method of identifying the aneurysmal source. While cerebral DSA offers advantages over CT angiography (CTA) and magnetic resonance angiography (MRA), it does so at the expense of greater risk. It carries a 1. 3-1. 8% risk of neurological complication and 0. 2-0. 3% risk of permanent deficit. Although DSA remains the most accurate technique for the diagnosis of cerebral vascular disorders, CT and MRI now play a significant part in the diagnosis and management of cerebral arteriovenous malformation (AVM). DSA is the gold standard in the detection and evaluation of intracranial vascular abnormalities when patients present with spontaneous ICH. Aneurysms and AVM are the typical causes of ICH uncovered by DSA. The procedure is invasive and carries a small but real amount of risk.
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Publisher: Cambridge University Press
Print publication year: 2009

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