In a retrospective study, we investigated the value of cerebral angiography in 64 patients with cerebral infarction aged 18–44 years. The patients were extensively investigated by computerized tomography, echocardiography, electrocardiogram, coagulation studies and other blood laboratory parameters. Forty-two patients were investigated by aortocervical angiography alone, 17 by both aortocervical and selective angiographies, and 5 by selective carotid or vertebral angiography alone. One patient who underwent selective carotid angiography developed transient neurological deficits, while none in the group who underwent aortocervical angiography developed any neurological complications. Thirty-seven (56%) of the patients had pathoiogical vascular lesions on angiography, located in arteries supplying the ischemic region. The most common findings were stenosis or occlusion of one carotid or vertebral artery. In 23 (36%) of the patients, angiography added clinically useful Information in determining the probable cause of the cerebral infarction. The corresponding figure for echocardiography was 11%. In 8 patients, the result of the angiography had a decisive influence on the treatment of the patient. Aortocervical angiography offered a satisfactory survey of lesions of the arteries from the aortic arch to the base of the skull. Selective angiography was necessary to identify 5 of the 8 patients in whom the pathological findings resulted in treatment. Thus, the adequate investigation of young patients with cerebral infarction should include both aortocervical and selective cerebral angiographies. Although cerebral angiography is associated with some risk of complication, it seems to be an acceptable risk in view of the diagnostic value.

Keywords:
Cerebral infarction, Cerebral angiography
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© 1991 S. Karger AG, Basel
1991
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