I have a pt who is interested in TMS for depression. She has a vascular stent in the Circle of Willis. The stent is rated for 3 T and can be used safely for MRI. This patient has actually also had a brain MRI since its installation. I have a NeuroStar system, which is 1.5 T at cranial surface. Their medical support team will not step outside the comfort of their own guidelines and will not endorse TMS use for this patient.
My question: What are your thoughts about TMS for this patient. My read is that it should be safe.
Hi, We are currently treating an 83 year old patient with Neurostar TMS who has a pipeline stent of R supraclinoid artery ICA anuerysm placed in 2015. Also post R CVA with left sided motor deficits and speech impairment. Every 2 years now (was more frequent) has 4T MRI to check on stent placement. Head of Tufts Neurosurgery, Dr Malek, who placed the stent, cleared him for TMS. He has done very well in TMS, greatly improved MDD. No side effects, no neurologic sx. Surgeon had no qualms clearing him for TMS.
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