Angiogram of the head and neck is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the blood vessels of the head and neck. An angiogram of the neck (carotid angiogram) can be used to look at the large arteries in the neck that lead to the brain. An angiogram of the head (cerebral angiogram) can be used to look at the veins or the four arteries (four-vessel study) carrying blood to the brain.

During an angiogram, a thin, soft tube called a catheter is placed into the femoral blood vessel (femoral artery) in the groin or just above the elbow (brachial artery). The catheter is guided to the head and neck area. Then an iodine dye (contrast material) is injected into the vessel to make the area show clearly on the X-ray pictures. The angiogram pictures can be made into regular X-ray films or stored as digital pictures in a computer.

An angiogram can find a bulge in a blood vessel (aneurysm). It can also show narrowing or a blockage in a blood vessel that slows or stops blood flow. An abnormal pattern of blood vessels (arteriovenous [AV] malformation) or abnormal vessels near a tumor can be seen.

See an illustration of the blood supply to the brain.

Magnetic resonance angiogram (MRA) and computed tomography angiogram (CTA) are being done instead of standard angiogram in many cases because these tests are less invasive and easier to do.

Why It Is Done

An angiogram of the head or neck is done to:

• Look for blockage or narrowing of the arteries in the neck that carry blood to the brain. Blood flow to the brain that is slowed or stopped increases the chance of having a stroke or a transient ischemic attack (TIA). See an image of an angiogram showing a person with a TIA.
• Study symptoms that might mean problems with the blood flow to the brain. Symptoms may include severe headaches, memory loss, slurred speech, dizziness, blurred or double vision, weakness or numbness, or loss of coordination or balance.
• Detect an aneurysm in the brain or in a blood vessel leading to the brain. See an image of an angiogram showing blood flow in the brain.
• Check the pattern of blood flow to a tumor. This can show if the tumor has spread and can help guide treatment.

How To Prepare

Before an angiogram, tell your doctor if you:

• Are or might be pregnant.
• Are breast-feeding. Use formula (throw out your breast milk) for 1 to 2 days after the angiogram until the dye has passed from your body. This generally takes 24 hours.
• Are allergic to iodine dye used in the test.
• Have ever had a serious allergic reaction (anaphylaxis) from any substance, such as the venom from a bee sting or from eating shellfish.
• Have asthma.
• Are allergic to any medicines.
• Have any bleeding problems or are taking blood-thinning medicines.
• Have a history of kidney problems or diabetes, especially if you take metformin (Glucophage) to control your diabetes. The dye used during an angiogram can cause kidney damage in people who have poor kidney function.