A mandatory six-week block of didactics is scheduled dealing with emergency management of acute ischemic stroke, intra-cerebral hemorrhage, sub-arachnoid hemorrhage, and subdual hemorrhage. Introductory lectures will be held on CT, CT angiogram, CT perfusion, MR imaging, MRA, and MR diffusion and perfusion imaging.
Weekly stroke conferences, journal clubs, and mortality and morbidity conferences augment the educational experiences. Standard textbooks dealing with acute stroke care, neurocritical care, neurosonology, neuroradiology and interventional radiology are available at both sites of training.
At Baylor St. Luke's and the DeBakey VA Medical Center, the vascular neurology fellow will work with registered vascular technologists (RVT's) in learning how to perform noninvasive studies of the cerebrovascular system via ultrasound technology. The vascular fellow will work with physicians experienced in interpreting the results of carotid ultrasound and trans-cranial Doppler. The fellow will also learn about the physics and biological principles behind the medical use of ultrasound technology. A one-month rotation in the vascular laboratory is planned.
The vascular neurology fellow will work directly with interventional neuroradiologists to learn the indications and limitations of interventional neuroradiological techniques in regards to stroke management. The vascular fellow will observe and participate in interventional procedures as per the interventional neuroradiologist. The fellow will participate in outpatient clinics where potential candidates are evaluated for neuro-interventional procedures. The procedures include carotid and intra-cranial stenting, intra-arterial thrombolysis (both mechanical and chemical), and endovascular treatment of intracranial aneurysms. One- to two-month rotations are planned for the vascular fellow depending on the interests of the fellow.
The vascular neurology fellow will learn about the indications and limitations of various diagnostic tests used to image the neuraxis. The fellow will work directly with neuroradiologist to acquire skills in interpreting these imaging studies. The imaging studies includes cranial and spinal magnetic resonance imaging (MRI) and computerized tomography (CT), magnetic resonance angiography (MRA), conventional cerebral angiography, carotid and cranial Doppler studies, single photon emission tomography (SPECT) and positron emission tomography (PET). One to two rotations are planned depending on the interests of the fellow.
The vascular neurology faculty has broad interests in different aspects of stroke research. Many are recognized leaders and published widely in the area of translational stroke, acute stroke research, health services research, clinical trial design and analysis, genetics and basic science of stroke. Mentoring program starting in the first year of fellowship program is possible for interested candidates.