Angiography in the evaluation of intracranial trauma.

Abstract

Angiography in the diagnosis of intracranial lesions is not a new procedure, having been developed in 1927 by Egas Moniz (2). The technic has not been widely applied, however, in the evaluation of intracranial mass lesions occurring as a result of trauma. Many surgeons have preferred to depend upon watchful waiting, with the employment of a trephine as indicated. Under this type of management the diagnostic error has been high (30 to 40 per cent). In an attempt to reduce this figure, we have been utilizing carotid arteriography with increasing frequency since 1949. Approximately 1,000 head injury patients are seen on the neurosurgical services of the Detroit Receiving, Detroit Memorial, and Grace Hospitals each year. About one-half of these present evidence of severe intracranial damage. It is in this latter group that angiography has been useful in determining the presence of intracranial hematoma, its extent, and its localization. In previous reports on this subject, 30 cases studied by angiography were...