Browsing articles by " Teri Polan"
ANEURYSMS
Aneurysms
An aneurysm is a bulge or “ballooning” in the wall of an artery. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of the body. If an aneurysm grows large, it can burst and cause dangerous bleeding or even death.
Most aneurysms occur in the aorta, the main artery traveling from the heart through the chest and abdomen. Aneurysms also can happen in arteries in the brain, heart and other parts of the body. If an aneurysm in the brain bursts, it causes a stroke.
Aneurysms can develop and become large before causing any symptoms. Often doctors can stop aneurysms from bursting if they find and treat them early. Medicines and surgery are the two main treatments for aneurysms.
NIH: National Heart, Lung, and Blood Institute
ALCOHOL
Alcohol
If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking is probably safe. It may even have health benefits, including reducing your risk of certain heart problems. Moderate drinking is one drink a day for women or anyone over 65, and two drinks a day for men under 65.
Some people should not drink at all, including alcoholics, children, pregnant women, people on certain medicines and people with some medical conditions. If you have questions about whether it is safe for you to drink, speak with your healthcare provider.
Anything more than moderate drinking can be risky. Binge drinking – drinking five or more drinks at one time – can damage your health and increase your risk for accidents, injuries and assault. Years of heavy drinking can lead to liver disease, heart disease, cancer and pancreatitis. It can also cause problems at home, at work and with friends.
NIH: National Institute on Alcohol Abuse and Alcoholism
MILD COGNITIVE IMPAIRMENT
Mild Cognitive Impairment
Some forgetfulness can be a normal part of aging. However, some people have more memory problems than other people their age. This condition is called mild cognitive impairment, or MCI. People with MCI can take care of themselves and do their normal activities.
MCI memory problems may include
- Losing things often
- Forgetting to go to events and appointments
- Having more trouble coming up with words than other people of the same age
Your healthcare provider can do thinking, memory, and language tests to see if you have MCI. He or she also may suggest that you see a specialist for more tests. Because MCI may be an early sign of Alzheimer’s disease, it’s really important to see your healthcare provider every 6 to 12 months.
At this time, there is no proven treatment for MCI. Your healthcare provider can check to see if you have any changes in your memory or thinking skills over time.
DEMENTIA
Dementia
Dementia is a word for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. People with dementia may not be able to think well enough to do normal activities, such as getting dressed or eating. They may lose their ability to solve problems or control their emotions. Their personalities may change. They may become agitated or see things that are not there.
Memory loss is a common symptom of dementia. However, memory loss by itself does not mean you have dementia. People with dementia have serious problems with two or more brain functions, such as memory and language.
Many different diseases can cause dementia, including Alzheimer’s disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve symptoms or slow down the disease.
NIH: National Institute of Neurological Disorders and Stroke
ALZHEIMER’S DISEASE
Alzheimer’s Disease
Alzheimer’s disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities.
AD begins slowly. It first involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or names of people they know. A related problem, mild cognitive impairment(MCI), causes more memory problems than normal for people of the same age. Many, but not all, people with MCI will develop AD.
In AD, over time, symptoms get worse. People may not recognize family members or have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home. Eventually, they need total care. This can cause great stress for family members who must care for them.
AD usually begins after age 60. The risk goes up as you get older. Your risk is also higher if a family member has had the disease.
No treatment can stop the disease. However, some drugs may help keep symptoms from getting worse for a limited time.
NIH: National Institute on Aging
Carotid Ultrasound
What is a carotid ultrasound?
A carotid ultrasound is a noninvasive, painless screening test. Your doctor uses an ultrasound to look at the carotid arteries in your neck and see the flow of blood through them. Ultrasound, also called sonography, uses sound waves instead of X-rays to produce images of the body’s organs and tissues. A carotid ultrasound is an important test that can detect narrowing, or stenosis of the carotid arteries. Carotid artery stenosis is a major risk factor for stroke.
You have two carotid arteries, one on each side of your neck. Carotid arteries are major arteries that carry blood from your heart to your brain. A buildup of plaque can narrow or block your carotid arteries. This is called carotid artery disease, which increases your risk of stroke.
A carotid ultrasound is only one method used to screen for carotid artery disease. You should discuss different screening options with your doctor to best understand which option is right for you.
Types of carotid ultrasounds
The types of carotid ultrasounds include:
- Doppler carotid ultrasound produces images of the flow of blood through your carotid arteries.
- Standard carotid ultrasound produces images of the physical structure of your carotid arteries.
A carotid ultrasound typically includes both types of ultrasound.
Why is a carotid ultrasound performed?
Acarotid ultrasound is a procedurethat your doctor may recommend to diagnose or screen diseases and conditions of thecarotid arteries including:
- Blood clot in the carotid arteries that can slow or block blood flow to the brain
- Carotid artery dissection, which is a split in the layers of the carotid artery wall. It can slow blood flow or dangerously weaken the wall of the artery.
- Carotid artery stenosis, which is a narrowing of the carotid arteries due to a buildup of plaque inside them. This is a major risk factor for stroke. Your doctor may suspect this condition if you have a carotid bruit (pronounced broo-E). A carotid bruit is an abnormal sound heard through a stethoscope in the carotid arteries. Other risk factors that may indicate the need for a carotid ultrasound include high blood pressure, advanced age, diabetes, high cholesterol, and a personal or family history of stroke or heart attack.
- Congenital malformations, which are carotid artery abnormalities that are present at birth
- Stroke and transient ischemic attack (TIA). A TIA is a group of stroke-like symptoms that generally resolve within 24 hours. However, they are warning signs that you are at risk for a severe stroke.
- Tumors. Rarely, tumors can develop where the carotid artery branches, compressing the artery and surrounding nerves.
How is a carotid ultrasound performed?
Your carotid ultrasound will be performed in a hospital or outpatient setting by a team led by a radiologist. A radiologist is a physician who is specialized in medical imaging. A radiologic technologist often performs the carotid ultrasound. A radiologic technologist is a medical professional who is specialized in medical imaging and the care of patients during imaging procedures.
The procedure will take less than an hour and generally includes these steps:
- You will dress in a patient gown or wear your own loose-fitting, open-necked clothing. You will need to remove all jewelry around your neck area.
- You will lie on your back on a procedure table. The radiologic technologist may move or tilt the table during your exam.
- Your radiologic technologist will put ultrasound gel on your neck. The gel helps the ultrasound equipment make full contact with your skin by eliminating air. It also allows the equipment to slide easily across your skin without discomfort.
- Your radiologic technologist will then place an ultrasound transducer on your skin. The transducer is a handheld wand that sends and receives the sound waves. The radiologic technologist presses it firmly onto your skin and moves it around to see the arteries and surrounding tissues. The transducer and sound waves are painless.
- You may have to move or tilt your head or shoulders to get the best angle for the transducer.
- Once the exam is complete, your team will wipe off the gel. The gel is water-based and washes away easily.
- You may wait a short period of time while the radiologic technologist or radiologist verifies that the imaging is complete. Usually, you can go home immediately after the exam.
Carotid Endarterectomy
What is a carotid endarterectomy?
A carotid endarterectomy is a surgery to remove plaque buildup from your carotid arteries. It is a treatment for carotid artery disease and can help prevent a stroke. Carotid endarterectomy involves opening the carotid arteries in your neck and removing the inner lining that has become diseased or damaged by plaque.
You have two carotid arteries, one on each side of your neck. They are the major arteries that carry blood from your heart to your brain. A buildup of plaque can narrow or block your carotid arteries. This is called carotid artery disease, and it puts you at risk for stroke.
Carotid endarterectomy is a major surgery with significant risks and potential complications. You may have less invasive treatment options depending on your specific circumstances. You should consider getting a second opinion about all your treatment choices before having a carotid endarterectomy.
Other procedures that may be performed
In addition to a carotid endarterectomy, your doctor may perform one or more diagnostic procedures. These procedures will tell your doctor how much plaque is in your carotid arteries. They include:
- Carotid angiography is a procedure that allows your doctor to take a picture or image (called an angiogram) of your carotid arteries
- Carotid ultrasound is a noninvasive, painless screening test that allows your doctor to examine your carotid arteries and evaluate the flow of blood through them.
Why is a carotid endarterectomy performed?
A carotid endarterectomy is a major surgical procedure that your doctor may recommend to treat carotid artery disease. Carotid artery disease is a buildup of plaque inside your carotid arteries. This narrows your carotid arteries and can eventually block them completely. Carotid artery disease is a serious health condition because it puts you at risk of having a stroke. A stroke is a block in the flow of blood to your brain.
Your doctor may recommend a carotid endarterectomy if other less invasive treatments are not an option. Talk with your doctor about all of your treatment options and consider getting a second opinion.
Your doctor may recommend a carotid endarterectomy if you have carotid artery disease and have any of the following conditions:
- Carotid artery stenosis of 60% or greater. Carotid stenosis is narrowing of your carotid arteries. Your doctor may decide that a carotid endarterectomy is a good preventive treatment for you if your carotid arteries have narrowed by 60% or more. This is true even if you do not have symptoms and have not had a stroke or a TIA.
- Prior stroke
- Prior transient ischemic attacks (TIAs). TIAs are a group of stroke-like symptoms that generally resolve within 24 hours. However, they are warning signs that you are at risk for a severe stroke.
How is a carotid endarterectomy performed?
A vascular surgeon will lead your surgical team and perform your carotid endarterectomy in a hospital. A vascular surgeon is a surgeon who specializes in surgical treatment of diseases of the blood vessels.
A carotid endarterectomy is an open surgical procedure. Open surgery allows your surgeon to directly view and access the surgical area. Your surgeon will make an incision in your neck to expose the diseased part of your carotid artery. Your surgeon will then either clamp your carotid artery closed or place a temporary shunt around your artery.
The next step involves cutting open the diseased part of the artery and removing the inner lining, including the plaque buildup. Your surgeon will then close your artery and unclamp it or remove the shunt. He or she will then close up the incision in your neck.
Open surgery causes a certain amount of trauma to tissues, so it generally takes some time to recover. Your surgeon will determine how long you need to stay in the hospital based on your procedure, age, medical history, and general health.
Types of anesthesia that may be used
Your surgeon will perform a carotid endarterectomy using a nerve block or general anesthesia.
- General anesthesia is a combination of intravenous (IV) medications and gases that put you in a special type of sleep. During general anesthesia, you are unaware of the procedure and will not feel any pain. In some cases, you may also receive a peripheral nerve block infusion in addition to general anesthesia. In a peripheral nerve block infusion, a liquid anesthetic is injected or flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
- A nerve block is also known as regional or local anesthesia. For regional anesthesia, your anesthesiologist or nurse anesthetist will inject an anesthetic medication around certain nerves in the neck to numb the neck. Your doctor may also inject anesthetic in the skin and tissues around the procedure area (local anesthesia).
You will be awake, but kept as comfortable as possible during this procedure. Because you are awake, your surgeon may ask you questions during the procedure. This will help monitor your brain’s response to decreased blood supply while your carotid artery is clamped shut.
What to expect the day of your carotid endarterectomy
The day of your surgery, you can generally expect to:
- Talk with a pre-operative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure that you sign the surgical consent. It is important to verify the correct side with the operating staff.
- Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member if possible. The surgical team will respect your privacy and give you blankets for modesty and warmth in the surgical suite.
- Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
- A surgical team member will start an IV.
- The anesthesiologist or nurse anesthetist will start your anesthesia. For general anesthesia, your anesthesiologist will place a tube in your lungs to protect and control your breathing. You will not feel or remember this or the surgical procedure as they happen. A catheter may be placed in your bladder to collect urine while you are asleep.
- The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the surgery and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of a carotid endarterectomy?
Any surgical procedure involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during the procedure or throughout your recovery.
General risks of surgery
The general risks of surgical procedures include:
- Adverse reaction or problems related to anesthesia, such as an allergic reaction and problems with breathing
- Bleeding, which can lead to shock
- Blood clots, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
- Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of carotid endarterectomy
Complications of carotid endarterectomy can be serious. You can best reduce the risk of potential complications and help manage complications if any occur by following the treatment plan you and your surgeon design specifically for you. Potential complications include:
- Bleeding in the brain and brain damage
- Death
- Heart attack
- Hyperperfusion syndrome. This can occur when your brain receives normal blood flow after it has had low blood flow to it. A severe headache that improves when you are upright is a classic symptom.
- Low blood pressure, which is usually temporary
- Nerve damage, which is usually temporary. This can make it difficult to swallow and cause numbness in your face.
- Re-stenosis (narrowing) or re-blockage of your carotid artery
- Seizures (rarely)
- Stroke
- Throat swelling making it difficult to breathe
Reducing your risk of complications
You can reduce the risk of certain complications by:
- Ensuring that all members of you care team are aware of any allergies you have
- Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery
- Informing your doctor or radiologist if you are nursing or if there is any possibility that you may be pregnant
- Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage
- Taking your medications exactly as directed
How do I prepare for my carotid endarterectomy?
You are a very important member of your own healthcare team. The steps you take before surgery can improve your outcome after the procedure. You can prepare yourself for a carotid endarterectomy by:
- Answering all questions about your medical history and medications you take. This includes prescribed medications, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, previous surgeries, medications, and allergies at all times.
- Getting pre-operative testing as directed. Testing varies depending on your age, health, and specific procedure. Pre-operative testing may include a chest X-ray, electrocardiography (ECG), blood tests, and other tests as needed.
- If you are overweight, talk to your doctor about losing weight before the surgery through a healthy diet and exercise plan.
- If you have high blood pressure, talk to your doctor about how to control it both before and after surgery. Good blood pressure control can help decrease your risk of complications with a carotid endarterectomy.
- Not eating or drinking just prior to surgery as directed. Your doctor may cancel your surgery if you eat or drink too close to the start of the procedure due to the risk of complications. These include choking on stomach contents during deep anesthesia.
- Stop smoking as soon as possible. Even quitting for a just few days can be helpful.
- Taking or stopping medications exactly as directed. For a carotid endarterectomy, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during the doctor’s office visit. You may also think of other questions after your appointment. You should contact your doctor with any concerns before surgery.It is also a good idea to bring a list of questions to your pre-operative appointments. Questions can include:
- Why do I need a carotid endarterectomy? Are there any other options for treating my condition?
- How long will the surgery take? When will I be able to go home?
- What restrictions will I have after the surgery? When can I expect to return to work and other activities?
- What kind of assistance will I need at home?
- What medications will I need before and after the surgery?
- How will you manage my pain?
- How should I contact you? When should I see you in follow-up? Ask for numbers to call during and after regular hours.
What can I expect after my carotid endarterectomy?
Knowing what to expect can help make your road to recovery after a carotid endarterectomy as smooth as possible.
How long will it take to recover?
You will need to stay in the hospital for several days after your carotid endarterectomy. After the surgery, you will stay briefly in the recovery room until you are fully alert, breathing effectively, and your vital signs are stable. You may have a drain in your neck to help drain excessive fluids. Your doctor usually removes the drain within a day.
Occasionally, you may be able to go home on the same day if your surgery is very early in the day and you are recovering well. In most cases, a hospital stay of one to two daysis required.
Recovery after surgery is a gradual process. How long it will take for you to recover and return to normal activities depends on the specific surgery, your general health, age, and other factors. Your neck may hurt for several days after surgery. You might also experience some discomfort when swallowing for a few days. Full recovery may take several weeks.
Will I feel pain?
Pain control is an important element to healing and a smooth recovery. There will be discomfort after your surgery. However, you can expect your doctor and care team to manage your pain effectively. This will keep you comfortable so you can get the rest you need. Contact your doctor if you are in pain despite following your pain management plan or if your pain gets worse or changes.
When should I call my doctor?
After a carotid endarterectomy, you should keep your follow-up appointments. You should call your doctor if you have concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
- Change in level of consciousness or alertness, such as passing out, dizziness, unresponsiveness, or confusion
- Change in vision
- Chest pain, chest tightness, chest pressure, or palpitations
- Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.
- Inability to urinate or have a bowel movement
- Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
- Numbness or weakness on one side of your body or face
- Pain that is not controlled by your pain medication
- Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
- Severe headache
- Sudden confusion, problems with speaking or memory, vision problems, dizziness, trouble walking, or loss of balance
- Swelling in your neck
- Uncontrolled or heavy bleeding
- Unexpected drainage, pus, redness or swelling of your incision
How might a carotid endarterectomy affect my everyday life?
A carotid endarterectomy may cure your condition so you can lead an active, normal life. However, it will not prevent carotid artery disease from coming back. You can make changes to your everyday life that may help prevent or delay recurrence of carotid artery disease, such as:
- Eating a heart-healthy diet
- Getting regular exercise
- Maintaining a healthy weight
- Practicing stress management techniques
- Quitting smoking
- Taking blood thinning medications, such as aspirin or clopidogrel (Plavix), as directed by your healthcare provider
- Treating other related conditions, including high blood pressure, high cholesterol, and diabetes
Cerebral Angiography
What is cerebral angiography?
Cerebral angiography is a procedure that allows your doctor to take a picture or image (an angiogram) of the blood vessels in your brain. Doctors use cerebral angiography to study blood vessels in your brain that are obstructed, blocked, narrowed, enlarged or malformed, and diagnose the underlying cause.
Cerebral angiography is only one method used to diagnose a variety of cerebrovascular diseases, disorders and conditions.You should discuss different screening options with your doctor or healthcare provider to best understand which option is right for you.
Types of cerebral angiography
The types of cerebral angiography procedures include:
- Cerebral angiography is an angiographic procedure that involves inserting a catheter into a blood vessel in your groin or arm. The catheter wire is then fed, or guided to the area in the brain to be examined. X-rays are used to produce the angiogram, or picture of the vessel. Contrast or dye is injected into the catheter to produce images of the blood vessels in your brain.
- Noninvasive cerebral angiography uses computed tomography (CT) or magnetic resonance imaging (MRI) to produce the angiogram. MRI of blood vessels is also called magnetic resonance angiography, or MRA. CT involves X-rays but MRA does not.
A cerebral angiogram, and in some cases, noninvasive cerebral angiography, use a contrast agent, sometimes called a dye. This is given intravenously (through an IV). The contrast agent greatly improves the quality of the image produced.
Why is cerebral angiography performed?
Your doctor may recommend cerebral angiography to diagnose a variety of diseases and conditions of the blood vessels in the brain including:
- Aneurysms, which are weakened or diseased areas of a blood vessel that become enlarged or bulge. Aneurysms can occur in the brain and other areas of the body and can lead to serious or life-threatening bleeding if they rupture or burst.
- Atherosclerosis, or narrowing of the arteries
- Blood clots, which may be the cause of stroke
- Blood vessel malformations, which are usually present at birth, but may become a problem at various ages from birth to adulthood
- Brain tumors. A doctor may order cerebral angiography to confirm a brain tumor or understand what blood vessels are connected to the tumor.
- Cerebrovascular disease, including stroke and transient ischemic attack (TIA, a condition in which a person has temporary stroke-like symptoms)
- Dissection or splitting of the vessels leading to the brain
- Pre-surgery evaluation. A doctor may order cerebral angiography to evaluate the blood vessels in the head and neck before brain surgery or other invasive treatment.
- Vasculitis, which is an inflammation of the blood vessels that can occur in the brain
How is cerebral angiography performed?
Your cerebral angiography will be performed in a hospital or outpatient setting by a neuroradiologist. A neuroradiologist is a physician who specializes in diagnosing diseases of the nervous system using radiological imaging. The neuroradiologist may lead a cerebral angiography team. Either a radiologist or a radiologic technologist will lead a noninvasive cerebral angiography team. The procedure takes from one to three hours and generally includes these steps:
- You will dress in a patient gown and lie on a procedure table.
- Your team will insert an IV to provide fluids, medications, or a contrast agent.
- Your team will attach devices to monitor your heart rate and blood pressure.
- Your team will position your head and may hold it in place with a strap or other device.
- For cerebral angiography:
- Your team will take a small amount of blood for laboratory tests to verify that your kidneys are functioning properly and your blood is clotting adequately.
- Your team may give you sedative medications through the IV to help you relax.
- Your physician will determine the location to insert the catheter. The catheter is often placed in the artery in the groin . The area will be shaved, cleaned and numbed before a small incision is made. Your physician will insert the catheter and wire through the incision and guide it to the vessel to be examined.
- Once the wire is in place, your team will deliver the contrast agent through the catheter and take X-rays as the contrast agent flows through your blood vessels. You may feel a sensation of warmth when the contrast agent is injected.
- Your team will tell you when to hold still for the X-rays and may ask you to briefly hold your breath.
- When the procedure is complete, your team will remove the IV and catheter and the catheter site will be closed.
- For noninvasive cerebral angiography:
- If MRI is used, your team will give you earplugs because the machine makes loud thumping and humming noises. Closed MRI machines are long cylinders, so your team may give you a mild sedative if you are claustrophobic. The procedure table will slide into the machine for the test.
- CT machines also have a tunnel, but it is much shorter than an MRI tunnel. The procedure table will slide into the machine for the test. Your team may ask you to briefly hold your breath during the imaging procedure.
- If a contrast agent is used, it will be administered through your IV. You may feel a sensation of warmth when the contrast agent is injected.
- For MRIs, it is very important for you to lie completely still during the entire procedure. Any movement may cause the images to be blurry and could result in the need to repeat the procedure. The MRI procedure takes about an hour.
- When the procedure is complete, you may be asked to wait until the radiologist verifies that the imaging is complete. A member of the angiography team will remove your IV.
Will I feel pain?
Your comfort and relaxation is very important to both you and your care team. You may feela pinch or pin prick painduring the IV placement, but the imaging itself is painless. For catheter cerebral angiography, you should expect that sufficient pain and sedative medications will be given to you so that you stay comfortable. Sedative medications may also be given for MRI procedures if you are claustrophobic. If you are uncomfortable in any way, tell a member of your healthcare team.
What are the risks and potential complications of cerebral angiography?
Complications after cerebral angiography are uncommon. However, any procedure involves risks and the possibility of complications that may become serious in some cases. Complications can develop during the procedure or throughout your recovery. Risks and potential complications of cerebral angiography include:
- Adverse reaction or problems related to sedation or contrast agents, such as an allergic reaction and problems with breathing
- Bleeding or clotting problems
- Damage to an artery from the catheter
- Exposure to ionizing radiation, which may be harmful in excessive doses
- Infection
- Injury from metal objects in or on your body or in the room during an MRI
- Kidney injury from the contrast agent, especially if you have kidney disease
- Stroke
Reducing your risk of complications
You can reduce the risk of certain complications by:
- Ensuring that all members of your care team are aware of any allergies you have, especially to shellfish or iodine
- Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
- Informing your doctor if you have any metal in your body, including screws, pins, plates, pacemakers, implants of any kind, intrauterine devices (IUDs), and bullet fragments
- Informing your doctor if you have kidney disease or diabetes
- Informing your doctor or technologist if you are nursing or there is any possibility that you may be pregnant
- Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
- Removing all jewelry and metal objects and leaving them outside the MRI room. This includes glasses, credits cards, hair accessories, and removable dental work.
- Taking your medications exactly as directed
How do I prepare for my cerebral angiography?
You are a very important member of your own healthcare team. The steps you take before your procedure can improve your comfort level and help your doctor obtain the most accurate results. You can prepare yourself for cerebral angiography by:
- Answering all questions about your medical history and medications you take. This includes prescribed medications, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
- Arranging for a ride home if sedation will be used during your cerebral angiography
- Following exactly any instructions about eating and drinking before cerebral angiography
- Leaving jewelry, metal objects, credit cards, and other valuables at home
- Taking or stopping medications exactly as directed. For catheter cerebral angiography, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. With certain types of contrast dyes, you should not take metformin (Glucophage) for 48 hours before and after your angiography. Your doctor will give you specific instructions about taking your medications.
Questions to ask your doctor
Preparing for cerebral angiography can be stressful. It is common for patients to forget some of their questions during a brief doctor’s office visit. You may also think of other questions after your appointment. You should feel free to contact your doctor about any questions. It is a good idea to bring a list of questions to your appointments. Common questions include:
- Why do I need cerebral angiography? Are there any other options for diagnosing or treating my condition?
- How long will the procedure take? When will I be able to go home?
- What restrictions will I have after the procedure and when can I expect to return to work and other activities?
- What restrictions will I have after the procedure and when can I expect to return to work and other activities?
- What kind of assistance will I need at home? Will I need a ride home?
- What medication plan should I follow before and after the procedure?
- How will my pain or anxiety be managed?
- When should I follow up with you? Ask for numbers to call during and after regular hours.
- When will I receive the results of my test?
- What other tests or procedures might I need?
What can I expect after my cerebral angiography?
Knowing what to expect after cerebral angiography can help you get back to your everyday life as soon as possible.
How will I feel after the cerebral angiography?
After the procedure, you may have mild drowsiness if you receive sedative medications. It is unlikely that you will feel pain after cerebral angiography. However, with catheter cerebral angiography, it is common to experience mild tenderness and bruising at the catheter incision site. Let a team member know if you are uncomfortable.
Your activities may be restricted following a catheter cerebral angiography. Follow your doctor’s instructions for eating, drinking and resting after cerebral angiography.
When can I go home?
You will need to stay in the outpatient facility or hospital for a short period of time after your cerebral angiography. For catheter cerebral angiography, you will likely be monitored for four to six hours after the procedure before being discharged to go home.
For noninvasive cerebral angiography, you are usually allowed to go home immediately after the procedure unless you receive sedative medications. You will be discharged home when you are fully alert, breathing effectively, and your vital signs are stable. This generally takes less than an hour, depending on the type of sedation you receive.
If you have sedation for either procedure, you will not be able to drive for about 24 hours and you will need a ride home from your procedure. Because you may still be a bit drowsy, someone should stay with you for the first 24 hours.
When should I call my doctor?
After cerebral angiography you should keep your follow-up appointments and feel free to call your physician if you have any concerns between appointments. Call your doctor if you have:
- Bleeding
- Chest pain
- Difficulty walking or talking or moving a body part normally
- Dizziness
- Facial weakness or facial drooping
- Fever
- Numbness or a feeling of coolness in the arm or leg that was used to insert the catheter
- Pain
- Slurred speech
- Unusual swelling
- Vision problems