arteriovenous malformation (for Seltzer-Martin grading and plan for intervention), dural arteriovenous fistula, embolisation of brain tumours such as meningioma, cavernous sinus haemangioma, for Wada test, and to obtain haemodynamics of cerebral blood flow such as cross flow, circulation time, and collateral flow. Extracranial diseases are: Subclavian steal syndrome, rupture of the carotid artery, carotid artery stenosis, cervical spine trauma, epistaxis (nose bleeding) and plan for embolisation of juvenile nasopharyngeal angiofibroma before operation. Although computed tomography angiography (CTA) and Magnetic resonance angiography (MRA) has been used widely in evaluation of intracranial disease, cerebral angiography provides higher resolution on the conditions of blood vessel lumens and vasculature. Cerebral angiography is also the standard of detecting intracranial aneurysm and evaluating the feasibility of endovascular coiling. Certain conditions such as contrast allergy, renal insufficiency, and coagulation disorders are contraindicated in this procedure. Technique Before the procedure, focused history and neurological examination is performed, available imaging, and blood parameters are reviewed. When reviewing imaging, arch anatomy and variants are evaluated to select suitable catheters to assess the vessels. Complete blood count is reviewed to ensure adequate amount of haemoglobin in subject's body, and to rule out the presence of sepsis. Serum creatinine is assessed to rule out renal dysfunction. Meanwhile, prothrombin time is assessed to rule out coagulopathy. Informed consent regarding the risks of the procedure is taken. Anticoagulants are withheld if possible. Fasting is required 6 hours before the procedure and insulin requirement is reduced by half for those diabetics who are fasting. Bilateral groins (for femoral artery access) and left arm/forearm (for brachial artery/radial artery access) are prepared. Neurological status of the patient before sedation or anesthesia is recorded. Sedation drug such as intravenous midazolam and painkiller such as fentanyl can be used if the subject is restless or painful. The subject is then lie down on supine position with arm at the sides. Uncooperative subjects may have their forehead tapped to reduce motion. The subject is advised to stay as still as possible especially when fluoroscopy images are taken. The subject is also advised to avoid swallowing when images of neck are taken. These measures are taken to reduce motion artifact in the images. Right common femoral artery (RFA) is the preferred site of access. If RFA access is not optimal, then brachial artery access is chosen. Either a micropuncture system or an 18G access needle can be used with or without