Affiliations: Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
Note: [] Corresponding author: Manraj K.S. Heran, Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, 899 West 12th Ave, Vancouver, BC V5Z 1M9, Canada. Tel.: +1 604 875 4111; 63384; Fax: +1 604 875 4723; E-mail: manraj.heran@vch.ca.
Abstract: Catheter cerebral angiography in the pediatric population remains the ‘gold standard’ diagnostic modality for assessment of a number of neurovascular disorders. Although its use has declined due to advances in noninvasive imaging techniques, its ability to resolve and provide dynamic assessment of small vessels, vascular lesions and arteriovenous shunts/fistulae makes it an invaluable tool in the assessment and treatment planning for a number of cerebrovascular disorders. A number of subtle and significant differences exist between pediatric and adult cerebral catheter angiography, including methods of vascular access, catheter selection, contrast administration, and sedation requirements. Similarly, the indications for cerebral angiography are more varied compared with adults. Understanding the differences between pediatric and adult cerebral catheter angiography is essential to ensure safe and appropriate use of the investigation, and to minimize the associated risks. The selective intracarotid administration of sodium amytal (Wada) test is a tool for assessment of language dominance and memory in a select group of patients for preoperative epilepsy surgery planning. In addition to discussing the principles of the test, indications and contraindications, a number of specific issues pertaining to performing the Wada test in the pediatric population will also be addressed.
