Neurointervention · IR Playbook

Wada Test with Intracarotid Drug Injection (WADA)

The Wada test is a diagnostic angiographic procedure in which a short-acting anaesthetic is injected selectively into one internal carotid artery to transiently inactivate that hemisphere and lateralise language and memory before epilepsy surgery or other resective neurosurgery. The mechanism is a brief, territory-limited pharmacological hemispherectomy — the drug distributes only through the injected vascular territory, so the neuropsychological deficits produced map onto that territory and the intact contralateral hemisphere is tested in isolation. Its value depends entirely on the injected drug reaching the intended territory and nowhere else, which is why cross-flow, ophthalmic reflux and posterior communicating spill are the dominant sources of an uninterpretable test.

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