Angiography

Hi all! I’ve posted a couple times including once last week about advice for an angiogram. Here’s the update of how it went…!

I had it yesterday morning and it wasn’t the most fun procedure. It was decently painful and I ended up crying when they injected some contrast and my head went all spinny, which I wasn’t expecting. They did find an AVM. It’s relatively small and in an area of my brain called the Pons(??) which apparently isn’t brain tissue but is vaguely near to my brain stem.🧠 Idk honestly but the nurse said it’s the first time she’s seen one in that area, so I guess that’s cool? I’ll wait to hear back about what they recommend in a couple weeks.

Now onto the aftermath. The first hour was ok, then my vision went horrible and I could barely open my eyes. I got seriously nauseous and my hands and face were tingling and fuzzing and I had a temperature. Then my hands got stuck in one position and I couldn’t clench them, and I swear I couldn’t get my words out, as in I was forgetting words and couldn’t speak properly. They had to get a neurologist in to check me out.

They then sent me for an MRI to check if something had gone wrong. I almost threw up all over the machine. Thankfully nothing wrong from the blood tests and MRI, but I then spent the next few hours lying down throwing up and unable to open my eyes because of my headache. They concluded it must have been a bad reaction to the contrast, and after much paracetamol and two anti emetics I’ve come home and am resting.

Overall 0/10 would not recommend having a reaction to contrast, very bad vibes.

Hey everyone. Occipital AVM Back Right, on Oxcarbazepine 600mg, tomorrow I am going in for my Craniotomy for my AVM. I started having seizures 2020 and only have had 5 so far. CAT scans revealed 1x1x3 Lesion/Drainage vein thingy hanging out in the back right of my brain. I am really nervous about how I'll be feeling after the surgery, anyone have any advice regarding recovery post craniotomy? My AVM is grade 1, apparently chilling near the surface of my brain. Everyone have a great night!

I wanted to share my experience regarding the procedure for a cerebral angiogram. Hopefully it will be helpful to someone having a similar experience.

I got to the hospital just after 07:00, the front desk confirmed my details and after a short wait I was taken to my bed, the nurse gave me a quick run down of the procedure and afterwards I changed in my gown.

A junior doctor then came and took some bloods and fitted my with a cannula in my left arm. He proceeded to do some simple neurological tests, such as pupil dilatation, coordination tests etc., nothing crazy.

I then was told they would take me down to the ward and wait there until it was time to do my procedure. I was lucky, by this time it would have been 08:30. I waited in the ward for about 30-60 minutes and was then taken to the theatre where they would do my angiogram.

The room was cold, so they put a couple of warm blankets on me and fitted the ECG equipment.

 The angiogram would be done through my right wrist, they put some tape across my hand so it would be able to move during the procedure, just on strip of tape. They then cleaned my wrist with the blue surgical soap. They draped the surgical sheet across me and secured my arm a little more with some padding. 

The nurse then gave me a sedative, which was basically a small dose of valium and fentanyl. Honestly I don’t think I needed it in hindsight but it was nice to have. It just gave me a calmness I wouldn’t have had otherwise.

After this was done the local anaesthetic was injected into my right wrist, it stung a bit but not that bad. The doctor then punctured the artery and inserted the catheter, I didn’t really feel anything except a slight pushing/pressure. After this I was awake but not really aware. The doctor went up into my neck through the right radial artery and then it was time to inject the iodine dye. It was a strange feeling, I think they injected in 4 different places, it was like a warm sensation that rushed through my head. Again, I wasn’t really aware besides that feeling and being told to hold my breath as the took the images/x-rays.

Once it was completed the doctor pulled out the catheter and place an inflatable wrist wrap to keep pressure where the puncture was made. By this time the sedative was slowly starting to fade, the nurses got me ready to be taken back to the ward. I waited there for about an hour with the nurses on the ward checking me every 10 minutes or so. 

After they were happy I was taken back to the day procedure area and had a glass of water and repeated the same neurological tests I had done with the junior doctor before the procedure. I was then checked over with my blood pressure and bpm etc. before being discharged.

I was really nervous before this procedure but honestly it was fine. I didn’t have anything to worry about. Apart from the local anaesthetic needle there was no pain. Every single one of the staff was amazing. 

I didn’t get my results right away but the doctor told me after the procedure that I should expect good news in the report which I am still waiting for as it hasn’t even been a day since I have had it done.
 I hope someone can get something out of this post. In my experience, you have nothing to worry about for this type of angiogram.

First, just want to say thanks to this sub again as always! So many posts and comments recommended seeing a neurointerventional radiologist, and I had to push and push for the referral, and it did not disappoint.

He was so much more knowledgeable and understanding than any specialist I've seen. I had already done a ton of reading about stents, here are a few things the doc told me about IIH and stents that I didn't already know:

• There isn't research yet on patients being taken off of low-dose aspirin, which is why most docs at this time plan to keep patients on aspirin for life unless/until more research is published.

• Much of what we know about the long-term risks of stents is extrapolated from artery stents, which have been around much longer.

• Lumbar punctures are very often done incorrectly, and many many patients with IIH are not properly diagnosed due to false pressure readings. Neurointerventional radiologists often see these patients for pulsatile tinnitus only to discover that they also have IIH despite having a "normal" LP reading. This doc insisted that LPs really should be done on your side for a proper reading, LPs done while seated or lying on your stomach can produce artificially low pressure readings.

Just thought I'd share these tidbits that I learned and didn't remember already seeing on this sub. He also told me a lot more about angiograms and pressure gradients and stent candidacy, but I think those topics have been thoroughly covered in lots of other posts.

I have a lot to think about now, as the doc left it up to me whether to pursue a stent or try another medication increase. I have decision fatigue after 5 months of preoccupation with this condition... sigh.

1/10 Do not recommend.

On the plus side, I have a good heart - much to my ex wife's surprise.

Had an angiogram yesterday at Foothills medical center. When asked if I wanted something to reduce my stress and anxiety during the procedure, I said yes and They gave me Fentanyl. Awesome. Good times, good times.