Cerebral fluorescein angiography: key to diagnosing neurological diseases

Cerebral fluorescein angiography is an advanced diagnostic technique that allows the observation of blood flow in the brain using fluorescent imaging. This procedure is essential for the detection and treatment of various neurological diseases, such as strokes, aneurysms, and arteriovenous malformations.

What is cerebral fluorescein angiography?

Cerebral fluorescein angiography is an imaging study that involves injecting a fluorescent contrast agent into the vascular system to observe blood flow in real time.

1. How it works: the contrast agent, usually based on fluorescein or indocyanine green, highlights the blood vessels when illuminated by a special light, allowing detailed images of the flow to be captured.
2. What does it show?: the condition of the cerebral arteries and veins, as well as the presence of blockages, malformations, or bleeding.

How is a cerebral fluorescein angiography performed?

The procedure follows these steps:

1. Prior preparation: the patient must inform the physician of any allergies, medications they are taking, or conditions such as pregnancy or kidney failure. Fasting is generally required to avoid gastrointestinal complications that may arise from the contrast agent.
2. Contrast injection: the contrast agent is administered through an intravenous line.
3. Image capture: a specialized camera takes images while the contrast agent circulates through the blood vessels of the brain.
4. Post-procedure monitoring: the patient is observed for a short period to ensure there are no adverse reactions.

Main applications of cerebral fluorescein angiography

Cerebral fluorescein angiography is used in various neurological conditions, such as:

1. Stroke: it allows the identification of areas of ischemia or cerebral infarction. It is useful for assessing the degree of obstruction in the blood vessels and planning treatments such as thrombolysis.
2. Cerebral aneurysms: helps locate and assess the size and shape of aneurysms, which is essential for deciding on surgical or endovascular management.
3. Arteriovenous malformations (AVMs): detects abnormal connections between arteries and veins, providing essential information for planning therapeutic interventions.
4. Inflammatory or autoimmune diseases: such as cerebral vasculitis, where it is necessary to assess the condition of the vessels to adjust treatment
5. Brain tumors: determines the tumor’s vascularization, which is important for planning surgeries or additional therapies.

Advantages and limitations

1. Advantages: high accuracy in detecting vascular alterations; real-time images of blood flow; detailed information that helps in planning medical or surgical procedures.
2. Limitations: risk of allergic reactions to the contrast agent; contraindicated in patients with severe kidney failure or allergies to fluorescent contrast agents; it is an invasive procedure that requires strict medical supervision.

Considerations for patients

Before undergoing cerebral fluorescein angiography, it is essential to consider the following:

1. Medical preparation: it is essential to inform the physician of any allergies or kidney problems you may have.
2. Potential risks: although rare, allergic reactions or kidney complications may occur.
   Post-procedure follow-up: if you experience discomfort or side effects such as dizziness or nausea, you should contact your physician immediately.

Cerebral fluorescein angiography and strokes

In the context of strokes, cerebral fluorescein angiography is an essential tool for:

1. Distinguishing between ischemia and hemorrhage: essential for selecting the appropriate treatment.
2. Identifying the exact location of the obstruction: which allows interventions such as mechanical thrombectomy to be carried out with greater precision.
3. Assessing reperfusion after treatment: to verify the effectiveness of the therapy applied.

Conclusion

Cerebral fluorescein angiography is an essential procedure for diagnosing and treating various neurological diseases, especially those affecting cerebral circulation. Although it is an invasive study, the benefits it offers far outweigh the risks when performed by trained professionals. Thanks to its ability to provide detailed images of blood flow in the brain, this technique remains fundamental in the management of critical conditions such as strokes, aneurysms, and vascular malformations, helping to save lives and improve patients’ quality of life.

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