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Neurology (Expert Forum)
Brain Angiogram? Possible CNS Vasculitis
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Brain Angiogram? Possible CNS Vasculitis
by Pamela__0__0, Nov 14, 1997 12:00AM
Re: Brain Angiogram? Possible CNS Vasculitis
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Posted by CCF Neuro MD *!* on November 24, 1997 at 21:24:31:
In Reply to: Brain Angiogram? Possible CNS Vasculitis posted by Pamela on November 14, 1997 at 15:51:08:
: I will be having a brain angiogram very soon to look for possible CNS Vasculitis. But it is more likely that I have something else, none of the many doctors (including neurologists at Georgetown, Mayo, and Hopkins) I have seen have been able to figure it out. A brain biopsy was considered but ruled out as too dangerous by the Neurosurgeon. I have various lesions in my brain most are in the white matter, these are on the brainstem and near the ventricles. But I also have a GREY MATTER lesion in my right occipedal (sp?) lobe, this is the one causing the vasculitis concern. I also have Lymphocytes in my CSF. There are no other indications of vasculitis. My doctor is really concerned about finding the cause of my lesions because I had a very bad time this summer from the brainstem lesion and he says I can't afford another one. (My heart rate hovered around 30 for several days and the vertigo was so severe that I could not move my head for nearly a month.) Other diagnosies that have been considered are Atypical MS, Chronic meningitis, and some sort of unidentified virus.
I would like to know what to expect from the angiogram, any special preparation, possible risks, recovery info, and if there are any alternative or additional tests I could have done. Does the angiogram test for anything besides vasculitis? Would a SPECT scan provide the same information, I know it measures blood flow. How could I find out where to have a SPECT scan done in my area? (DC/Baltimore) Also, can you think of any unusual conditions that we could test for?I appreciate any info you can provide.
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Dear Pamela,
It certainly seems that you a very complex disorder which has baffled many doctors so far . I would not attempt to suggest a diagnosis based on the limited information in your message but I can definitely give you some data on the angiogram.
The angiogram procedure basically involves inserting a very fine tube thorough a needle placed in the femoral artery in the groin and threading it up through the aorta to the blood vessels which supply your brain, at this point a dye is injected and X-rays are taken, the dye fills the vessel and the outline of individual vessels is seen on the x ray film. In vasculitis the blood vessels are inflamed and distorted and the variation in shape and calibre is seen on the X ray film.
The test would also identify anatomical abnormalities like aneurysms (swelling of a vessel at a weak point), vessels which are occluded by a clot , as in strokes , AVM’s’ which are tangled masses of overgrown vessels or the distinctive pattern of vessel growth found around a tumor.
A SPECT scan measures blood flow in a different way, it shows the overall amount of blood flow in a given area, but does not identify individual vessels, for this reason an angiogram would be the obvious test for vasculitis, but this does not preclude SPECT being suggested at a later date.
As regards special preparations , I would not think anything is needed apart from any instructions you may be given with regard to fasting , the risks are those of any invasive procedure i.e. infection , bleeding at the site of puncture in the groin and in the case of brain angio a very small risk of stroke If you need a SPECT scan I am sure the scan is available in Johns Hopkins
You might ask your neurologists if they have considered Behcets disease although I suspect this has been considered a long time ago.
I wish you luck with your ongoing evaluation.
This information is provided for general medical education purposes only.
Please consult your physician for diagnostic and treatment options of your specific medical condition.
