CT Head (Cerebral) Angiography.pptx, Arterial supply of the brain. 1- internal carotid artery. 2- vertebral artery. Aneurysm Narrowing of artery in the brain, Abnormal blood vessels Investigating source of haemorrhage

1. CT Head (Cerebral) Angiography
Rukamanee
Assistant Professor
Department of
Radiology & Imaging
Technology
Mewar University

2. What is Cerebral Angiography
 Study of blood vessels in the body by injecting
a contrast media through particular arteries
and veins that is called the angiography.
 Cerebral angiography is a procedure that use
the contrast media and CT equipment to see
the blood flow of brain.
 And diagnosis the brain pathology.
 This is minimally invasive procedure.

3. Anatomy of Head
 Arterial supply of the brain.
 Major blood supply to the brain by the two artery-
 1- internal carotid artery.
 2- vertebral artery.
 Internal carotid artery arise from the point of neck.
 These arteries are in pairs and supply the blood in both
side of brain.
 The major blood supply by internal carotid artery to
cerebrum. 80 percent.
 It is the part of front brain.

4. Blood supply of brain

5. Indications
 Aneurysm
 Narrowing of artery in the brain
 Abnormal blood vessels
 Investigating source of haemorrhage.
 Blockage of carotid artery
 Stenosis

6. Conti..
 To determine future risk of stroke
 Severe headaches
 Slurred speech
 Dizziness
 Blurred or double vision
 weakness or numbness
 Loss of coordination or balance.

7. Contraindication
 Pregnancy
 Unstable vital sign
 Allergic patient
 Kidney problems
 Severe diabetes
 Hepatic failure
 Patient declined consent

8. Equipments
 CT SCAN equipment with control console
 Contrast media
 Needle (18 gauge)
 Surgical blade
 Saline
 Heparin
 Local anesthesia
 Elastoplast
 Gloves
 Gown
 Anti-allergic drugs
 Pressure injector

9. Patient Preparation
 Take previous history and clinical
examination.
 Informed consent.
 Patient should be well hydrated.
 Fasting 4 hours prior to procedure.
 Shave and clean the arterial puncture site.
 Xylocaine sensitivity test.

10. Con….
Following investigations to be done :
 Hb% and and platelet count
 ESR
 PT, (prothrombin time) BT and CT
 HBsAg (hepatitis B surface Antigen)
 Pulse chart
 Any history of drug intake.
 History of diabetes .

11. Patient Position
 Patient position on CT scan table in supine
position.
 Head first and arm beside the trunk
 patient head will place using a strap, tape or
a foam head holder so patient cannot move it
during the procedure.
 Placed the IV cannula .(18 gauge)
 To ensure that cannula is not block.
 Scan orientation –caudo cranial

12. INJECTION OF CONTRAST
WITH NEEDLE IN SITU
 Feel the inguinal ligament.
 Feel the artery and fix it with three fingers of left
hand below the inguinal ligament.
 Inject the local anaesthetic agent at the site of the
puncture .
 Make a hole in skin using a thick needle 2½ cm (1
inch) below the inguinal ligament or give a stab
incision.
 Then inject the contrast media.
 Volume of contrast media-
 Then take the image.

13. Complications
1.Due to local anaesthesia
(a) Allergic
(b) Toxic-due to injection in the vein, e.g.cardiac
arrhythmias
2. Due to contrast media
Mild
Moderate
Severe contrast reactions
Pain may follow injection of contrast material into the
vessel.

14. TOPOGRAM IMAGE

15. Conti…..

16. Post processing technique
 Commonly used technique-
 MIP (Maximum Intensity Projection)
 MPR (Multiplanar Reconstruction)
 VRT (Volume Rendering Technique)

17. Advantages
 CT angiography may give more accurate
anatomical details compare to MRI .
 Minimal invasive and minimum risk .
 Low cost examination.
 Aneurysms can be best diagnosed by
angiography.
 Many patient can undergo CT angiography
instead of catheter angiography to daignose the
blood vessels.

18. Disadvantages
 Radiation exposure
 Risk of contrast reactions.

19. After care
 Bed rest
 Keep the puncture part without moving for
atleast 6-8 hrs.
 Watch for any recurrence of bleeding.
 Peripheral pulses should be monitored/Vitals
monitored.
 Hydrate the patient well.
 Deterioration of renal function should be
watched .

20. THANK YOU