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MRgFUS · WHO IS ELIGIBLE?

Who is Eligible for MRgFUS? — Assessment Criteria and Skull Density Ratio Explained at KIMS Hyderabad

Q: I was told by a neurologist that I am not eligible for MRgFUS because of my skull. What does this mean and are there other options?

Your neurologist is referring to a low skull density ratio (SDR) — a measure of how well ultrasound can pass through your skull bone. The SDR is the main technical barrier to MRgFUS: if the skull bone is too dense and absorptive, not enough ultrasound energy can reach the brain target to create the therapeutic lesion, even at maximum machine power. Approximately 20–30% of otherwise eligible patients have an SDR below the 0.4 threshold. If your SDR is low, three alternative surgical options are available: (1) RF thalamotomy (radiofrequency thalamotomy): the most direct surgical comparator to MRgFUS — it creates the same permanent Vim thalamic lesion, but through a small burr hole and an inserted electrode, so skull density does not matter. (2) Deep brain stimulation (DBS): DBS implants electrodes directly into the Vim thalamus under stereotactic guidance — there is no skull bone ultrasound transmission requirement. DBS is highly effective and is the most widely performed surgical tremor treatment. (3) Gamma Knife thalamotomy (stereotactic radiosurgery): Gamma Knife uses focused radiation beams to create a Vim thalamic lesion — radiation penetrates bone without difficulty, so SDR is irrelevant. The Gamma Knife lesion develops over 4–12 months (slower than MRgFUS but ultimately comparable in effect). At KIMS, all three alternatives are available and the team will guide you to the most appropriate option for your specific situation. Call 040-44885000.

Q: I am 82 years old with essential tremor. Am I too old for MRgFUS?

No — there is no upper age limit for MRgFUS. The procedure is particularly well-suited to older patients because it requires no general anaesthesia and no surgery. In published clinical series, including the pivotal NEJM 2016 trial, patients in their late 70s and 80s achieved tremor reduction equivalent to younger patients, with similar side effect rates. The age-related considerations at KIMS are: (1) MRI scan duration: patients must lie flat in the MRI scanner for 1.5–2 hours. This is generally well-tolerated but patients with severe kyphosis (curvature of the spine from age-related compression fractures) or severe hip or knee pain may find this difficult. Padding and positioning adjustments minimise this issue. (2) Cognitive function: patients must be able to provide verbal feedback during the procedure (“Is the tremor better? Do you have any tingling?”). Mild cognitive slowing is acceptable; significant dementia is not. (3) General medical status: well-controlled common elderly conditions (hypertension, type 2 diabetes, cardiac disease) are not barriers. The KIMS team performs a standard pre-procedure medical assessment for all patients, with specific attention to the age-related factors above. Call 040-44885000.

Q: I have a metal hip replacement. Can I still have MRgFUS?

A hip replacement is not a contraindication to MRgFUS or to MRI in general. Modern hip prostheses are MRI-compatible and are made of titanium, cobalt-chrome, or ceramic — materials that are MRI-safe and do not cause significant image distortion in the region of the head. MRI of the head in a patient with a hip replacement is routinely performed throughout radiology. The MRI-incompatible metal implants that are contraindications for MRgFUS are those in or near the head: older-model cardiac pacemakers and defibrillators · Non-MRI-compatible cochlear implants · Aneurysm clips of unknown composition in the brain · Ferromagnetic dental implants (very rare). Spinal hardware, orthopaedic implants in the limbs and hips, coronary stents, and most modern surgical implants are MRI-compatible. When in doubt about a specific implant, bring the device card or implant information to the assessment at KIMS and the MRI safety team will advise. Call 040-44885000.

Q: My tremor affects both hands. Can MRgFUS treat both sides?

MRgFUS can only treat one side at a time — it creates a lesion in one thalamus (the left Vim thalamus to treat the right hand, or the right Vim thalamus for the left hand). Bilateral MRgFUS thalamotomy (treating both hands) is not recommended because bilateral thalamic lesions significantly increase the risk of permanent speech difficulty (dysarthria) and swallowing problems. For patients with significant bilateral hand tremor, DBS is the more appropriate choice: bilateral DBS is standard practice, and the stimulation can be carefully programmed to balance tremor control with the minimisation of side effects on both sides simultaneously. If only one hand is significantly more affected than the other, MRgFUS of the dominant hand (the more important hand for function) can provide substantial functional improvement even without treating the other side. Many patients with bilateral tremor find that treating just the dominant hand restores the most functionally important activities (eating, writing, drinking) even when the non-dominant hand continues to shake. At KIMS, the movement disorders team assesses the bilateral tremor pattern and provides a personalised recommendation. Call 040-44885000.

Clinical eligibility (diagnosis, medication history, tremor severity), technical eligibility (SDR ≥ 0.4), and the full same-day assessment pathway — for essential tremor and tremor-dominant Parkinson's disease at KIMS Neuroscience, Secunderabad, Hyderabad.

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Two Categories of Eligibility — Clinical and Technical

Not everyone with essential tremor or Parkinson's disease tremor is a candidate for MRgFUS. Eligibility is determined by a combination of clinical criteria (the diagnosis, severity, and medication history) and a technical criterion that is unique to focused ultrasound — the skull density ratio (SDR). Understanding both categories of eligibility helps patients know whether it is worth coming for an assessment, and what the assessment at KIMS will involve.

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Same-day eligibility assessment — clinical review, skull CT for SDR calculation, and brain MRI in a single visit.

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★ Definition — Skull Density Ratio (SDR)

Why SDR ≥ 0.4 is the Threshold for MRgFUS

The skull density ratio (SDR) is a measurement derived from a CT scan of the head that reflects how well ultrasound energy can pass through the individual patient's skull bone. An SDR of 1.0 represents a skull that transmits ultrasound perfectly; an SDR of 0.0 represents a skull that blocks ultrasound completely. Patients with an SDR of 0.4 or above are eligible for MRgFUS; those below 0.4 cannot be adequately treated because insufficient ultrasound energy reaches the brain target.

SDR ≥ 0.4 — the criterion that excludes 20–30%: The skull density ratio (SDR) is a numerical measure of how well ultrasound energy can pass through an individual patient's skull bone, derived from a thin-slice CT scan of the head. SDR 1.0 = a skull that transmits ultrasound perfectly; SDR 0.0 = a skull that blocks it completely; SDR ≥ 0.4 = eligible for MRgFUS. Approximately 20–30% of otherwise clinically eligible patients have an SDR below 0.4 and cannot be adequately treated because insufficient ultrasound energy would reach the target. The SDR cannot be changed by any means.
What clinical eligibility requires: Three clinical criteria must all be met: (1) Diagnosis: essential tremor (ET) of the hand and arm, or tremor-dominant Parkinson's disease. (2) Medication failure: tried and failed at least two appropriate medications at adequate doses — propranolol + primidone for ET; levodopa ± dopamine agonist for PD. 'Failed' means inadequate control OR intolerable side effects. (3) Disability threshold: tremor must significantly impair daily function (writing, eating, drinking, work).
What is NOT treatable by MRgFUS: MRgFUS is NOT indicated for tremor from multiple sclerosis; cerebellar ataxia-related tremor; drug-induced tremor (lithium, valproate, antipsychotics — medication adjustment is first-line); dystonic tremor; or psychogenic (functional) tremor. Patients with these diagnoses are not candidates and are counselled accordingly at the KIMS eligibility assessment.
MRI compatibility — what rules out and what does not: Non-MRI-compatible implants rule out MRgFUS because the entire procedure is performed inside the MRI scanner. Rule-outs: older-generation cardiac pacemakers or defibrillators that are not MRI-compatible; non-MRI-compatible cochlear implants; metal hardware in the head or brain. Does NOT rule out: modern MRI-conditional pacemakers (confirm model); hip replacements; spinal hardware below the head; coronary stents; most abdominal surgical clips.
Procedure tolerance — the four practical requirements: To undergo MRgFUS, the patient must: (1) be able to lie flat and still inside an MRI scanner for 1.5–2 hours; (2) be able to give verbal feedback during the procedure; (3) not have severe claustrophobia unresponsive to oral anxiolytics; (4) not have severe coagulopathy (the stereotactic frame is secured with scalp pins). There is no strict upper age limit — the oldest trial patients were in their 80s.
The same-day eligibility assessment: One visit, four steps, same-day result. Step 1: Clinical consultation (60–90 min) — TETRAS (ET) or MDS-UPDRS (PD) assessment, history, medication review, spiral drawing and writing sample, video of baseline tremor. Step 2: CT scan — thin-slice CT head/skull to assess skull density ratio (SDR) and bone suitability for ultrasound transmission. Step 3: MRI brain — confirms target anatomy, identifies the thalamic target, and checks for contraindications. Step 4: Same-day eligibility decision and consent. If SDR < 0.4, the patient is told the same day, sparing further visits.

The Four Eligibility Pillars

The MRgFUS Eligibility Stack at KIMS

MRgFUS eligibility rests on four pillars — clinical eligibility, the SDR threshold, MRI compatibility, and procedure tolerance. Each is assessed in the same-day pathway at KIMS.

The Diagnosis & Disability Side

Clinical Eligibility

Essential tremor or tremor-dominant Parkinson's disease that has failed at least two appropriate medications (propranolol + primidone for ET; levodopa-carbidopa ± agonists for PD), with tremor severity that significantly impairs daily function on the TETRAS or MDS-UPDRS.

The Technical Side

Skull Density Ratio (SDR) ≥ 0.4

Calculated from a thin-slice CT — measures how well ultrasound can pass through the patient's specific skull bone. Approximately 20–30% of otherwise eligible patients have an SDR below 0.4 and cannot be treated by MRgFUS.

Implants & Safety

MRI Compatibility

No non-MRI-compatible pacemaker, defibrillator, cochlear implant, or head/brain metal hardware. Hip replacements, spinal hardware, coronary stents, and most modern body implants are MRI-compatible and do not exclude the patient.

Cognitive & Physical

Procedure Tolerance

Able to lie flat in an MRI scanner for 1.5–2 hours · Able to give verbal feedback during the procedure · No severe claustrophobia unresponsive to anxiolytics · No active severe psychiatric illness · No significant coagulopathy.

Section 1

Clinical Eligibility Criteria

Diagnosis — what conditions are currently treatable

MRgFUS is FDA-approved and clinically established at KIMS for two indications: (1) Essential tremor (ET) of the hand and arm: the most common movement disorder in adults over 60. The tremor occurs during action (reaching, holding a glass, writing) and is not present at rest. (2) Tremor-dominant Parkinson's disease: the resting tremor of Parkinson's disease in the dominant hand, where tremor is the most disabling feature. MRgFUS is not currently used for: tremor from multiple sclerosis · Cerebellar ataxia-related tremor · Drug-induced tremor · Dystonic tremor · Psychogenic tremor · Parkinson's disease where bradykinesia and rigidity are the primary complaints (DBS is more appropriate).

Medication history — failed medical treatment is required

MRgFUS is not first-line treatment. The clinical criterion requires that the patient has: tried and failed at least two appropriate medications for their tremor type · For ET: propranolol (or atenolol if propranolol is not tolerated) AND primidone at adequate doses · For PD tremor: levodopa-carbidopa at adequate doses, with or without dopamine agonists · “Failed” means either the medication was not effective (inadequate tremor control) or the side effects were not tolerable at the doses needed for tremor control. Patients who have never tried medical treatment will be offered medication optimisation before MRgFUS is considered.

Tremor severity — the disability threshold

MRgFUS is appropriate when the tremor significantly impairs daily function. The KIMS assessment uses standardised tremor severity scales (the Essential Tremor Rating Assessment Scale, ETRAS, and the TETRAS — The Essential Tremor Rating Assessment Scale for ET; the MDS-UPDRS tremor subscale for PD) to document severity. Patients with mild tremor that does not significantly interfere with daily activities are typically counselled to continue with medication optimisation before proceeding to MRgFUS.

Age and general health — who is a good candidate

MRgFUS has no strict upper age limit. The oldest patients treated in clinical trials were in their 80s. General health requirements: the patient must be able to lie flat in an MRI scanner for 1.5–2 hours without significant discomfort (patients with severe musculoskeletal conditions may have difficulty) · Cognitive function must be sufficient to provide feedback during the procedure · No severe anxiety or claustrophobia that cannot be managed with anxiolytics · No significant coagulopathy (the frame pins penetrate the scalp; abnormal bleeding would be a problem).

Section 2

The Skull Density Ratio (SDR) — The Key Technical Eligibility Criterion

Why the skull matters for focused ultrasound

Ultrasound waves interact with bone differently from soft tissue. When ultrasound travels through bone, it is partially reflected, partially scattered, and partially absorbed as heat within the bone itself. If the skull bone is very dense (thick compact bone with little porous structure), a large proportion of the ultrasound energy is absorbed and reflected by the bone rather than transmitted to the brain. This reduces the energy available at the target and causes the skull to heat up — which must be managed by simultaneous skull cooling. If the skull bone is excessively absorptive (SDR below 0.4), insufficient energy reaches the Vim thalamus to create an effective lesion, even at maximum power.

How the SDR is measured

The SDR is calculated from a thin-slice CT scan of the head (1 mm slices). The CT measures the X-ray attenuation (density) of the skull bone at many points. The SDR formula compares the density of the inner and outer cortical bone layers (compact bone, high density) to the diploe (the spongy cancellous bone between them, low density). A skull with high SDR has thin, dense cortical layers and a thick, porous diploe — this structure transmits ultrasound well. A skull with low SDR has very thick, uniformly dense bone that absorbs rather than transmits ultrasound. The CT for SDR measurement is performed at KIMS as part of the eligibility assessment and the result is available the same day. The KIMS team calculates the SDR using the Insightec-validated algorithm.

What happens if your SDR is below 0.4

Approximately 20–30% of patients who are clinically eligible for MRgFUS (correct diagnosis, failed medications, adequate tremor severity) have an SDR below 0.4 and cannot be treated. For these patients, the alternatives are: (1) RF thalamotomy (radiofrequency thalamotomy): the most direct surgical comparator to MRgFUS — it creates the same permanent Vim thalamic lesion, but through a burr hole and an inserted electrode rather than ultrasound, so skull density is irrelevant. (2) DBS (deep brain stimulation): there is no skull bone requirement for DBS; the electrodes are placed surgically and do not require ultrasound transmission. (3) Stereotactic radiosurgery (Gamma Knife thalamotomy): delivers radiation to the Vim target without skull bone transmission requirements, though with a latency of 4–12 months before the lesion is fully effective. The KIMS team discusses these alternatives with all patients who are found to be ineligible for MRgFUS due to SDR.

Section 3

Exclusion Criteria — Who Cannot Have MRgFUS

The table below summarises the exclusion criteria for MRgFUS at KIMS, the reason for exclusion, and the preferred alternative treatment pathway.

Exclusion Criterion

Reason

Alternative

SDR < 0.4

Insufficient ultrasound transmission through skull

RF thalamotomy · DBS · Gamma Knife thalamotomy

Cardiac pacemaker or defibrillator (non-MRI compatible)

MRI incompatible

Discuss with cardiologist — MRI-compatible devices sometimes eligible

Cochlear implant

MRI contraindication

DBS

Other MRI-incompatible metal implants in the head

MRI safety

Case-by-case evaluation

Active psychiatric illness (severe depression, psychosis)

Cannot provide reliable intraoperative feedback

Stabilise psychiatric condition first

Severe claustrophobia unresponsive to anxiolytics

Cannot tolerate MRI scanner for 1.5–2 hours

DBS if tremor is severe

Unstable cardiac disease (recent MI, severe CHF)

Procedure risk

Medically optimise and reassess

Significant coagulopathy or anticoagulation

Frame pin site bleeding risk

Adjust anticoagulation (discuss with haematologist)

Parkinson's with dementia or cognitive impairment

Cannot provide reliable feedback · DBS may be inappropriate too

Palliative management

Bilateral tremor requiring bilateral treatment

MRgFUS is unilateral only

DBS (bilateral stimulation is standard for bilateral tremor)

Tremor not from ET or PD (MS, ataxia, etc.)

No evidence base · Not approved

Disease-specific management

Section 4

The Eligibility Assessment at KIMS — What to Expect

The full eligibility assessment proceeds in four sequential stages — completed in a single day with a same-day result and same-day consultation.

Clinical assessment — 90 minutes

Detailed movement disorder history · Medication history review · TETRAS or UPDRS tremor scoring · Neurological examination · Functional assessment (observe writing, pouring water, Archimedes spiral drawing) · Cognitive screening · Psychiatric history · Cardiac and medical history review.

CT scan — CT head/skull for skull density ratio (SDR)

Low-dose thin-slice (1 mm) CT of the head without contrast: assesses the skull density ratio and bone suitability for ultrasound transmission. Takes 5–10 minutes. Results available within 1–2 hours using the Insightec algorithm. This is the most important eligibility test because it determines whether MRgFUS is technically feasible for that patient, so it is performed before the MRI.

MRI brain

3 Tesla MRI of the brain: confirms the target anatomy, identifies the thalamic target for planning, and checks for contraindications and structural abnormalities (tumour, haemorrhage, significant small vessel disease) that might affect safety or outcome. Can be performed at KIMS on the same day as the assessment if not recently available.

Same-day result and consultation

The KIMS MRgFUS team reviews all assessment data (clinical, CT/SDR, MRI) and provides a same-day eligibility decision and consultation. If eligible: procedure scheduling, pre-procedure instructions, and consent discussion. If not eligible due to SDR: discussion of alternatives (RF thalamotomy, DBS, Gamma Knife thalamotomy). If not eligible due to clinical criteria: medication optimisation plan or watchful waiting recommendation.

Key Clinical Facts

What Patients Should Know

MRgFUS eligibility at KIMS is decided in a single day on the basis of clinical and technical criteria. The following points summarise the most clinically significant facts every patient and referring physician should know.

MRgFUS is FDA-approved and offered at KIMS for essential tremor and tremor-dominant Parkinson's disease — not for MS, cerebellar ataxia, dystonic, drug-induced, or psychogenic tremor

Failed medical treatment is a prerequisite — propranolol + primidone for ET; levodopa-carbidopa ± agonists for PD tremor — at adequate doses, with documented inefficacy or intolerable side effects

Skull Density Ratio (SDR) is calculated from a thin-slice 1 mm CT using the Insightec-validated algorithm — KIMS provides same-day results

Approximately 20–30% of otherwise eligible patients have an SDR below 0.4 and are not technically treatable by MRgFUS — RF thalamotomy, DBS, and Gamma Knife thalamotomy are the alternatives at KIMS

There is no upper age limit — published series include patients in their late 70s and 80s with tremor reduction equivalent to younger patients

MRgFUS is unilateral only — bilateral thalamotomy significantly increases the risk of permanent dysarthria and swallowing problems

Hip replacements, spinal hardware, and coronary stents are MRI-compatible and not exclusions — only head/brain metal implants and older pacemakers are MRI contraindications

The full KIMS eligibility assessment (clinical review + skull CT/SDR + 3T MRI) is completed in a single day with a same-day result

Key Facts

MRgFUS Eligibility at a Glance

Fact	Details
Clinical eligibility	Diagnosis: ET or tremor-dominant PD · Failed ≥ 2 appropriate medications at adequate doses · Significant functional disability from tremor · TETRAS/MDS-UPDRS documented
Technical eligibility — SDR	Skull Density Ratio ≥ 0.4 on thin-slice CT · 20–30% of otherwise eligible patients excluded here · SDR cannot be changed · Same-day CT + SDR calculation at KIMS
MRI compatibility	No non-MRI-compatible pacemaker, defibrillator, cochlear implant, or head/brain metal · Hip replacements, spinal hardware, coronary stents generally compatible · Confirmed from device model numbers
Procedure tolerance	Able to lie flat 1.5–2 hours · Verbal feedback during procedure · No severe unresponsive claustrophobia · No significant coagulopathy · No strict upper age limit (oldest trial patients in their 80s)
Conditions NOT treatable	MS tremor · Cerebellar ataxia-related tremor · Drug-induced tremor · Dystonic tremor · Psychogenic tremor · PD where bradykinesia and rigidity dominate
Same-day eligibility assessment	1 visit: 60–90 min clinical consultation + CT (SDR) + 3T MRI + same-day eligibility decision + consent · Combined 2-day visit with treatment for out-of-Hyderabad patients
Contact	040-44885000 · neuroscience@kimshospitals.com · No referral required · Eligibility can be pre-screened by phone/email before the visit

Related Treatments

Explore related MRgFUS, DBS, and Gamma Knife pages at KIMS Neuroscience:

MRgFUS Focused Ultrasound Deep Brain Stimulation Gamma Knife Radiosurgery Functional Neurosurgery

Common Questions

Frequently Asked Questions

Your neurologist is referring to a low skull density ratio (SDR) — a measure of how well ultrasound can pass through your skull bone. The SDR is the main technical barrier to MRgFUS: if the skull bone is too dense and absorptive, not enough ultrasound energy can reach the brain target to create the therapeutic lesion, even at maximum machine power. Approximately 20–30% of otherwise eligible patients have an SDR below the 0.4 threshold. If your SDR is low, three alternative surgical options are available: (1) RF thalamotomy (radiofrequency thalamotomy): the most direct surgical comparator to MRgFUS — it creates the same permanent Vim thalamic lesion, but through a small burr hole and an inserted electrode, so skull density does not matter. (2) Deep brain stimulation (DBS): DBS implants electrodes directly into the Vim thalamus under stereotactic guidance — there is no skull bone ultrasound transmission requirement. DBS is highly effective and is the most widely performed surgical tremor treatment. (3) Gamma Knife thalamotomy (stereotactic radiosurgery): Gamma Knife uses focused radiation beams to create a Vim thalamic lesion — radiation penetrates bone without difficulty, so SDR is irrelevant. The Gamma Knife lesion develops over 4–12 months (slower than MRgFUS but ultimately comparable in effect). At KIMS, all three alternatives are available and the team will guide you to the most appropriate option for your specific situation. Call 040-44885000.

No — there is no upper age limit for MRgFUS. The procedure is particularly well-suited to older patients because it requires no general anaesthesia and no surgery. In published clinical series, including the pivotal NEJM 2016 trial, patients in their late 70s and 80s achieved tremor reduction equivalent to younger patients, with similar side effect rates. The age-related considerations at KIMS are: (1) MRI scan duration: patients must lie flat in the MRI scanner for 1.5–2 hours. This is generally well-tolerated but patients with severe kyphosis (curvature of the spine from age-related compression fractures) or severe hip or knee pain may find this difficult. Padding and positioning adjustments minimise this issue. (2) Cognitive function: patients must be able to provide verbal feedback during the procedure (“Is the tremor better? Do you have any tingling?”). Mild cognitive slowing is acceptable; significant dementia is not. (3) General medical status: well-controlled common elderly conditions (hypertension, type 2 diabetes, cardiac disease) are not barriers. The KIMS team performs a standard pre-procedure medical assessment for all patients, with specific attention to the age-related factors above. Call 040-44885000.

A hip replacement is not a contraindication to MRgFUS or to MRI in general. Modern hip prostheses are MRI-compatible and are made of titanium, cobalt-chrome, or ceramic — materials that are MRI-safe and do not cause significant image distortion in the region of the head. MRI of the head in a patient with a hip replacement is routinely performed throughout radiology. The MRI-incompatible metal implants that are contraindications for MRgFUS are those in or near the head: older-model cardiac pacemakers and defibrillators · Non-MRI-compatible cochlear implants · Aneurysm clips of unknown composition in the brain · Ferromagnetic dental implants (very rare). Spinal hardware, orthopaedic implants in the limbs and hips, coronary stents, and most modern surgical implants are MRI-compatible. When in doubt about a specific implant, bring the device card or implant information to the assessment at KIMS and the MRI safety team will advise. Call 040-44885000.

MRgFUS can only treat one side at a time — it creates a lesion in one thalamus (the left Vim thalamus to treat the right hand, or the right Vim thalamus for the left hand). Bilateral MRgFUS thalamotomy (treating both hands) is not recommended because bilateral thalamic lesions significantly increase the risk of permanent speech difficulty (dysarthria) and swallowing problems. For patients with significant bilateral hand tremor, DBS is the more appropriate choice: bilateral DBS is standard practice, and the stimulation can be carefully programmed to balance tremor control with the minimisation of side effects on both sides simultaneously. If only one hand is significantly more affected than the other, MRgFUS of the dominant hand (the more important hand for function) can provide substantial functional improvement even without treating the other side. Many patients with bilateral tremor find that treating just the dominant hand restores the most functionally important activities (eating, writing, drinking) even when the non-dominant hand continues to shake. At KIMS, the movement disorders team assesses the bilateral tremor pattern and provides a personalised recommendation. Call 040-44885000.

Find Out in a Single Day Whether MRgFUS is the Right Treatment for Your Tremor — at KIMS Hyderabad.

Find out in a single day whether MRgFUS is the right treatment for your tremor. The KIMS MRgFUS eligibility assessment — including clinical review, skull CT for SDR calculation, and brain MRI — is completed in one visit with a same-day result. Call 040-44885000.

040-44885000

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