ABSTRACT
This chapter reviews the role of interventional neuroradiology (INR) in the management of patients with pathologies of the head and neck and describes common techniques. Endovascular embolization originated in surgery when Brooks closed a cavernous-carotid fistula with a muscle embolus introduced by arteriotomy in 1930. The decision to perform an INR procedure depends on clinical and anatomical factors. Magnetic resonance (MR) or Computed tomography (CT) scanning is usually adequate for diagnosis and pre-operative assessment of head and neck lesions so digital subtraction angiography (DSA) is rarely needed unless there is a possible role for INR. Combining embolization using DSA means that the indications for INR techniques should be considered early in treatment planning. All these techniques are designed to improve the reliability of the test but the lack of a consensus protocol testifies to the fact that there remains a risk of the collateral blood flow being inadequate, despite normal test data.
