Diagnostic tests and procedures are vital tools that help physicians confirm or rule out the presence of a neurological disorder or other medical condition. A variety of diagnostic techniques are utilized to detect, manage, and treat neurological disease.

Some procedures are performed in specialized settings, conducted to determine the presence of a particular disorder or abnormality. Many tests that were previously conducted in a hospital are now performed in a physician’s office or at an outpatient testing facility, with little if any risk to the patient. Depending on the type of procedure, results are either immediate or may take several hours to process.

Sentient Neurocare Services is the largest provider of Transcranial Dopper and cerebral hemodynamic monitoring/diagnostic services in the country. Its services are delivered in an array of hospitals, skilled nursing facilities and physician offices.

Transcranial Doppler

Transcranial Doppler (TCD)

TCD is a testing technique that quantitatively determines the blood flow velocity in the major arteries of the brain and is often referred to as “the physician’s stethoscope for the brain.

TCD is particularly useful in detecting cerebrovascular disease which is characterized by obstructions and altered flow in these vessels. If a patient has had a diagnosis of stroke or transient ischemic attack (TIA), TCD is a useful tool for evaluation of this on an out-patient or bedside basis. TCD will permit the use of fewer angiographic/MRI/MRA/CT/CTA studies by allowing a less expensive and non-invasive evaluation of the cerebrovascular hemodynamic. In addition, according to the American Heart Association, cardio-embolic strokes represent 32% of all strokes and TCD is the only protocol that makes possible the recording of emboli in real-time when they occur in cerebral vessels.

TCD represents a key tool in Critical Care. Cerebral vasospasm and intracranial hypertension after aneurysm rupture, subarachnoid hemorrhage and traumatic brain injury are important sources or morbidity and mortality. TCD is the only medical diagnostic tool that allows us to evaluate patients with a potential emboli.

Many patients previously diagnosed with TIA actually have had strokes that may contribute to vascular dementia. Vascular Dementia and Alzheimer’s disease (AD) are the most common causes of age-associated dementia. Cerebrovascular disease is thought by many to worsen dementia of any type. According to the position statement from the American Association for Geriatric Psychiatry regarding Principles of Care for Patients with Dementia Resulting from Alzheimer Disease the management of vascular brain disease and its associated risk factors is now part of the care for disease treatment for AD (Am J Geriatric Psychiatry, 2006).

Additionally TCD “bubble testing” to diagnose patent foramen ovale (PFO) is available. New research and ongoing clinical trials suggest that there may be a direct connection between PFO, strokes and migraine headaches. TCD examination is performed for patients with symptomatic/asymptomatic carotid stenosis, stenosis in the major basal intracranial arteries, assessment of patterns and extent of collateral circulation in patients with known regions of severe stenosis or occlusion of the extracranial carotid arteries. TCD is also useful during intraoperative monitoring of vascular surgery, evaluation and follow-up of patients with vasoconstriction or spasm resulting from an illness, disease or injury, detection of arteriovenous malformations and studying their supply arteries and flow patterns and as an adjunct in the assessment of patients with suspected brain death.

Sentient Neurocare Services is led by one the world’s foremost authorities on transcranial Doppler methodology and its clinical applications, Alexander Razumovsky, Ph.D., F.A.H.A. Dr. Razumovsky participates personally in the training of all technologists and supervises their continuing medical education. Dr. Razumovsky reviews TCD testing for accuracy and relevance to the patient and is available to consult with patient’s physicians.

Sentient Neurocare Services provides:

  • Highly trained and credentialed technical staff
  • Fellowship trained medical staff
  • State-of-the art transcranial Doppler instrumentation
  • Mobile services that can be performed in a Private Practice or Hospital bedside setting
  • 24-hours and 48-hours report turnaround times to clients
  • We produce and deliver reports via our secure company web site, which physicians and health care specialists can access from any PC. We do it all in a timely and cost efficient manner, with a level of expertise and personal attention unmatched in the industry
Carotid Duplex

Carotid Duplex (CD)

Carotid duplex imaging is a noninvasive test that provides insightful information regarding the carotid arteries and allows for the evaluation of blood flow to the brain.

Ultrasound is used to examine the carotid arteries for the detection and assessment of possible underlying arterial disease. By using gray scale and spectral Doppler imaging, an evaluation of the vessel and the hemodynamic can be made. Evaluation of the carotid arteries helps to decrease the risk of a future stroke. High-frequency sound waves are directed from a hand-held transducer probe through the neck, these waves “echo” off the arterial structures and produce an image on a monitor which shows obstructions or narrowing of the arteries caused by atherosclerotic plaque or thrombosis (blood clots). This procedure is performed to evaluate symptoms including dizziness, memory loss, stroke, loss of control of muscles and other findings which might result from carotid artery stenosis.

Carotid duplex ultrasound is widely used to screen patients for carotid endarterectomy and if combined with MR angiography and transcranial Doppler may be an alternative to conventional angiography in the preoperative assessment. Angiography carries some risks, including a small incidence of stroke, which is one reason that physicians do not always use it as the first test to diagnose or follow carotid artery disease.

The accurate determination of the degree of carotid artery stenosis is important in the routine clinical assessment of patients with suspected or confirmed carotid artery disease. This information determines whether surgical referral is warranted, or if the patient is best served with antiplatelet medication and serial follow-up.

Sentient Neurocare Services is led by one the world’s foremost authorities on cerebrovascular testing with Doppler ultrasound utilization, Alexander Razumovsky, Ph.D., F.A.H.A. Dr. Razumovsky participates personally in the training of all technologists and supervises their continuing medical education. Dr. Razumovsky reviews testing procedures for accuracy and relevance to the patient and is available to consult with patients physicians.

Sentient Neurocare Services provides:

  • Highly trained and credentialed technical staff
  • Fellowship trained medical staff
  • State-of-the art transcranial Doppler instrumentation
  • Mobile services that can be performed in a Private Practice or Hospital bedside setting
  • 24-hours and 48-hours turnaround time to provide reports to the Hospital and Private Practice, respectively
  • We produce and deliver reports via secure company web site, which physicians and health care specialists can access from any PC. We do it all in a timely and cost efficient manner, with a level of expertise and personal attention unmatched in the industry
  • Many years of experience as an expert mobile service provider
Electroencephalogram

Electroencephalogram (EEG)

An electroencephalogram (EEG) is a test of the electrical potentials of the brain.

EEG records the activity of the brain’s cortex and assesses whether a brain is functioning at an altered level of awareness. This test is used to diagnose and evaluate seizures, syncope (loss of consciousness), coma, narcolepsy, stroke, transient ischemic attacks and/or other conditions where there is an altered state of awareness or consciousness. It is a test for the brain that is similar in principles to an EKG for the heart.

Sentient Neurocare Services (SNS) is pleased to offer EEG services to its clients and their patients. Sentient is very experienced in providing outsourced and mobile services. Our technologists are highly trained and experienced in a variety of clinical settings. Our professional medical staff is Fellowship trained and their services are available as needed.

SNS provides:

  • Highly trained technical staff
  • Fellowship trained medical staff
  • State-of-the art portable EEG machines
  • Mobile services that can be performed in a Private Practice or Hospital bedside setting
  • Extremely experienced mobile service provider
Diagnostic Testing FAQ

Diagnostic Testing – FAQ

Q: What do the tests do?

A: A transcranial Doppler (TCD) ultrasound measures the blood flow through the brain by bouncing sound waves off the vessels in the brain. A TCD is sometimes called the “Stethoscope for the brain”.

A Carotid Duplex (CD) ultrasound is a test for blood flow through the big arteries in the neck that carry blood to the brain. With CD and TCD we can measure both the blood flowing to the brain and then the blood flow within the brain.

An Electroencephalogram (EEG) records the electrical potentials from the brain in a similar way that an EKG records the electrical potentials of the heart.

Q: Does it hurt?

A: No. EEGs, TCDs and CDs tests do not hurt. There is no pain and no discomfort associated with these tests. They record the way blood is flowing (like a stethoscope) or the “electrical” activity of your brain the way an EKG does with our hearts.

Q: Do I need to do anything to prepare for the test?

A: For a TCD or CD, there are no special preparations. For an EEG, aside from your doctor’s orders, you should avoid any caffeine for three hours before the exam because often an EEG needs to record your brain activity while you are awake, drowsy, and during brief sleep, if possible.

Q: Are there any side effects or after effects of the test?

A: There are no side effects. There may be some ultrasound gel in your hair at your temples or neck after a TCD or CD respectively, or some electrode cream in your hair after an EEG which can be easily washed out.

Q: What does the test tell my doctor and me?

A: TCDs tell you about the blood flow in your brain. CDs tell you about the blood flowing into your brain. EEGs tell you about the electrical potentials of your brain.

Q: What can I expect to happen during the test?

A: You may be asked to turn your head, open and close your eyes, or perform a breathing exercise. However, generally the patient is asked to lie still and remain quiet during the tests.

Q: When will I get the results of my test?

A: The results are usually in your doctors’ hands the next day. If there is a need for faster results, let us know and we can process your data more quickly.

Q: How much does it cost?

A: Costs vary from region to region, state to state and clinic to clinic. You can call your doctor to learn his/her charges. Usually the costs are much less than an X-Ray or other imaging modalities, like MRI or CT.

Q: Who should I contact if I have more questions?

Please call the Sentient Administrative Office at 888-481-9185 or write us at inquiries@sentientmedical.com.