What criteria for diagnosis of cerebrovascular disease

  Whole brain angiography (DSA) is a method of diagnosing cerebrovascular disease by injecting contrast into the arteries of the brain, visualizing the vessels, taking rapid and continuous films, and diagnosing cerebrovascular disease based on the morphology and location of the vessels visualized.  With the development of science and technology, cerebral angiography has also been advancing. The current technique used is digital subtraction angiography, or DSA for short, which is done by applying a computer program for two imaging sessions, where the two digital signals are subtracted to eliminate the same signal and yield a contrast-only image of the blood vessels. This image is clearer and more intuitive than the conventional cerebral angiography used in the past, and some fine vascular structures can also be shown, and the contrast agent is now non-ionic, eliminating the need for iodine sensitivity testing. Technically, local anesthesia is generally used, the right femoral artery is cannulated, and then a contrast tube is passed through the abdominal aorta and aortic arch, and the left and right internal carotid arteries and vertebral arteries are selectively accessed and contrasted respectively.  Because DSA can not only clearly display the vascular images of the internal carotid artery, vertebrobasilar artery, large intracranial vessels and cerebral hemispheres, but also determine the blood flow of the arteries, it has been used in the examination of cerebrovascular diseases, especially for the qualitative and localized diagnosis of aneurysms and arteriovenous malformations, which is the best diagnostic tool. It not only provides the exact location of the lesion, but also gives a clear understanding of the extent and severity of the lesion, which provides a more reliable objective basis for surgery. In addition, DSA is also of high diagnostic value for ischemic cerebrovascular disease, as it can clearly show the narrowing and occlusion of arterial lumen and the establishment of collateral circulation, etc. For cerebral hemorrhage and subarachnoid hemorrhage, the cause of hemorrhage, such as aneurysm and arteriovenous malformation, can be further identified.  In conclusion, as the internationally recognized “gold standard”, DSA is a proven diagnostic method for the diagnosis of cerebrovascular disease. However, since it is an invasive test, the indications should be strictly controlled and performed in hospitals that have the conditions.