Catheter angiography is the gold standard for visualizing the cerebral circulation – it provides the best images, but it is an invasive test, requiring maneuvering a small catheter into the cerebral arteries and injecting contrast, and carries a small risk of iatrogenic stroke or dissection.

The video of the cerebral angiogram below shows contrast injection into the internal carotid artery. Contrast dye fills the middle and anterior cerebral arteries, then the capillaries, and finally you see the venous drainage into the superior saggital sinus, transverse sinus and internal jugular vein.

Catheter angiography can be diagnostic, or done as part of an intervention, such as stroke thrombectomy, stenting or coiling of an aneurysm.