The contribution of cerebral angiography in diagnosis.

Angiography is important in the diagnosis of central nervous system disorders. In operable lesions it not only discloses the location of the lesion but also gives valuable information regarding its character and surrounding vascular architecture. The technique of both the pericutaneous and the open methods is described. The advantages of the controlled automatic arteriograph are described as well as pertinent information regarding cerebral circulation time. The choice of contrast media and the advantages and disadvantages of each are described. The three phases of angiography important in diagnosis-the arterial phase, the capillary phase and the venous phase-are discussed. The indications and contraindications are briefly outlined with respect to neoplasms, trauma, hemorrhage, aneurysms and other such operable lesions. The characteristic changes produced by aneurysms, vascular malformations, neoplasms and other space-occupying lesions as related to the circulatory apparatus show variations characterizing the type of lesion encountered. Angiography in traumatic conditions, while limited, is of exceptional value in the diagnosis of obscure lesions, particularly the subdural hematomas.