Vascular imaging in transient ischemic attack and stroke

Vascular imaging in transient ischemic attack and stroke 

The main clinical indications for imaging the cerebral circulation are TIA (e.g. to identify arterial stenosis), acute ischemic stroke (e.g. to identify vessel occlusion), intracerebral hemorrhage (e.g. to identify an underlying vascular malformation) and possible arterial dissection, flbromuscular dysplasia or other arteriopathies, cerebral aneurysm, intracranial venous thrombosis or cerebral vasculitis. 

Compared with cut-film selective intra-arterial catheter angiography recorded directly on to X-ray film, intra-arterial digital subtraction angiography (DSA) (Fig. 12.1) is quicker the images are easier to manipulate and store and contrast resolution is better although spatial resolution is less. However, there is no evidence that less contrast is used or that it is much safer (Warnock et al. 1993). Even for imaging only as far as the carotid bifurcation. 

transient ischemic attack. Source From Gerraty ef al. (1996). 

stroke or death as a result of dislodgement of atheromatous plaque by the catheter tip dissection of the arterial wall thrombus formation on the catheter tip air embolism 

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