Review potential complications of cerebral angiography To present a case of ischaemic stroke following diagnostic cerebral angiography

Cerebral digital subtraction angiography (DSA) is an invasive procedure used for imaging the intracranial and cervical vessels. Indications include evaluation of subarachnoid haemorrhage, ischemic stroke, intracerebral haemorrhage, staging of cerebral aneurysm and arteriovenous malformation.1 Cerebral DSA is not without risk. Complications include: local wound complications (e.g. hematoma, thrombosis, infection, arterial dissection), non-neurologic systemic complications (e.g. headaches, nausea, contrast allergy, acute renal failure),2-5 and neurologic complications (e.g. transient ischemic attack, stroke).2-8 Proposed mechanisms for neurologic complications include thromboembolism from catheters or guidewires, and disruption of atherosclerotic...

A 69 year old female patient underwent cerebral DSA (Figure 1) two years post acute coiling of a right superior cerebellar artery aneurysm, to confirm and characterise recurrence of the aneurysm detected on follow-up MRA. She developed right-sided homonymous hemianopia 1 hour after an uneventful DSA procedure. MRI showed restricted diffusion of the medial left occipital lobe and posteromedial left thalamus (Figure 2). Aspirin 500mg IV was administered and IV fluids commenced. One day post-procedure residual inferior right quadrantanopia was noted. Repeat MRI showed medial...

Cerebral angiography carries a small risk of serious neurologic complication. Prior to performing investigations, it is important to consider the risks and benefits of each modality for individual patients.

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