The Role of Complete Cerebral Angiography in Neurosurgery

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Figures

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    Case 1. Arteriovenous malformation distal to carotid siphon. Some dye is in general cerebral circulation. A portion of dye is in anterior cerebral artery, as shown in Film 3.

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    Case 2. Lateral view illustrating short-circuit lesion. Dye is already entering longitudinal sinus in Film 2, taken approximately 1½ seconds after injection.

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    Case 2. Contralateral carotid injection shows dye entering both hemispheres through collateral circulation.

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    Case 3. Note that all blood is out of cranial cavity in Film 3. The short time for passage of blood is due to short-cut lesions.

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    Case 4. The complete seriogram shows retarded circulation. Blood is still in arterial system through the entire series of films. Lesion proved to be primarily a venous thrombosis and acute swelling in the temporoparietal region. This was the first seriogram taken with the finally improved instrument (35 per cent diodrast).

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    Case 5. Thrombosis of middle cerebral artery. Films 4 and 5 suggest invasion of the anterior cerebral artery into the ischemic area. Temporal artery is visible. Dye in arterial system indicates general retardation of blood flow.

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    Case 6. In Film 4 cloudy opacity is interpreted as capillary phase, which best demonstrates the tumor. Persisting dye in Film 6 indicates retarded circulation in hemisphere.

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    Case 7. Arteriogram illustrating cannulated portion of carotid aneurysm. [Film accidentally was photographed on wrong side, giving the appearance of a left-sided lesion. Actually the lesion was on the right side. Film was lost, making correction impossible.]

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    Case 7. Artist's drawing showing approximate location of bilateral carotid aneurysms and phantom of angiogram.

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