Dear Colleagues,

Cerebral angiography is instrumental in identifying acute vessel occlusion in stroke, hemorrhage, intracranial artery stenosis, arteriovenous malformation, arterial dissection, venous outflow obstruction, and arterial aneurysm. Multiple modalities of imaging including computed tomography angiography (CTA), magnetic resonance angiography (MRA), and 3D or 4D digital subtraction angiography (DSA) have been used to visualize and map abnormal cerebral vasculature. Furthermore, the need for intraoperative imaging often guides the decision for neurosurgical intervention such as extent of nidus resection in arteriovenous malformation and choice of vascular access. Angiography is also used to monitor patients post-operatively, inform their care, and additionally screen for atherosclerotic plaque as a preventative measure. Consequently, it is emergently important to remain apprised of current literature expanding on the socioeconomic, clinical, and diagnostic utility of cerebral angiography. 

Recent studies have been published discussing the novel use of deep learning and generative adversarial networks in reducing artifact and identifying cerebrovascular pathology. To augment current diagnostics, artificial intelligence is being trialed in the detection of large-vessel occlusion in stroke for mechanical thrombectomy candidacy. Additionally, current undergoing research weighs the cost effectiveness, efficacy, availability, and accuracy of DSA, MRA, and CTA, influencing clinical guidelines and diagnostic algorithms for intracranial hemorrhage and post-embolization monitoring. In the field of preventative care, studies have investigated the use of cerebral angiography as a monitoring tool for Moyamoya disease and preventative screening measure for atherosclerosis of the middle cerebral artery in patients with considerable coronary artery disease and other cardiovascular risk factors. Within the pediatric population, research is being conducted on the efficacy of various modalities of imaging on monitoring for arterial segment hypoplasia as well as post-operative outcomes following imaging necessary for venous sinus thrombosis. This section will summarize and review updates in the approaches and uses of cerebral angiography in diagnosis of a variety of neurological diseases and populations. 

Dr. Brandon Lucke-Wold; Aashka Patel

Section Editors