Effects of Transcranial Doppler on Therapeutic Decisions in Neurologic Patients

Document Type : Research Paper




ntroduction: TCD is an expensive diagnostic investigation for patients and health insurance companies. Based on the therapeutic view, cost-effectiveness of transcranial doppler (TCD) is important in patients with cerebrovascular disease.
Material and Methods:This descriptive study was conducted in Neurosonology Center, Ghaem Hospital, Mashhad, within 2006-2007. Indication of TCD was made by neurologists previously. 200 TCD on 166 patients was performed by neurosonologists based on the standard protocol with AKAI device, France and 2MHz probe. The effect of TCD results on changing the dose and type of medicine and neurosurgical consultation of the patients was recorded. Data was analyzed with descriptive statistics and frequency distribution tables.
Results: 166 patients (64 males and 80 females) with mean age of 53.4 years were investigated. Abnormal results were found in 27.5% of TCD. Performance of 3D TCD (15%) had influence on therapeutic decisions of the patients. Among this later group, 83% were patients with subarachnoid hemorrhage and 17% had high risk cardiac source of embolism or sever carotid stenosis with recurrent cererbral ischemic events. The cost of 200 TCD in non-private center was evaluated to be about 10 million thomans.
Conclusion:Due to high expenses and low percentage of therapeutic influences, performance of TCD is recommended in a restricted group of patients. However TCD is a safe and non-invasive test for assessent of main cerebral arteries, which provide useful information.


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