The Clinical Utility of Transcranial Doppler Ultrasound in Suspected Vertebrobasilar Ischemia

The impact of transcranial Doppler ultrasound (TCD) on the management of 107 consecutively referred patients with suspected vertebrobasilar ischemia was studied. Physicians who referred patients for TCD of the posterior circulation were interviewed before and after being given the results of the TCD examination. Management plans devised prior to knowledge of the TCD results were compared to those devised after TCD results were given. Management changed in 42% of the patients after TCD results were given, and there was a 58% reduction in the use of angiography (p = 0.04) and a 128% increase in the use of aspirin (p = 0.005). Changes in the use of anticoagulants and other diagnostic or therapeutic approaches were not significant. TCD appears to have a significant impact on the management of patients with suspected vertebrobasilar ischemia.

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