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Indiana University School of Medicine
Indiana University School of Medicine
Neurology

Curriculum

The curriculum and didactic experience for the Vascular Neurology Fellowship is robust. Faculty stroke experts provide the following fellowship lecture series:
  

Topic/Faculty

 Description 
Intravenous Thrombolysis
(Richard Scheer, MD) 		Overview of the guiding principles for the use of intravenous thrombolysis in clinical practice. Includes a review of evidence supporting the use of Alteplase and Tenecteplase, a review of complications and their management, and the evidence supporting exclusion criteria when they arise complications) and a discussion of selected exclusion criteria and how they modify treatment risk.

Mechanical Thrombectomy (Kaustubh Limaye, MD)

 

Overview of the evidence supporting the use of mechanical thrombectomy in the treatment of acute ischemic stroke—including a review of early and late window trials. A brief overview of the thrombectomy techniques available will be included. The risks of MT and management of potential complications will be discussed.

Basic Sciences
(Linda Williams, MD)

 

Overview of stroke-related basic science. Topics covered include cerebral blood flow and metabolism (including the neurovascular unit and its role in cerebral autoregulation), the histopathology of atherosclerosis, arteriosclerosis, neuronal ischemia and reperfusion, and cellular mechanisms of ischemia-induced neuronal cell death.
 

Stroke Radiology
(Atul Aggarwal)

 Discusses the interpretation of multiple radiographic modalities as they relate to ischemic and hemorrhagic stroke—including CT, CT Perfusion, and MRI. The temporal evolution of vascular insults (ischemic, hemorrhagic, etc.) on each of these modalities will also be discussed. The appearance of vascular malformations on imaging

Management of Patent Foramen Ovale
(Georges Ephrem, MD)

 		 Overview of embryology and pathology as it relates to PFO is provided. Following this, the epidemiology of PFO-related stroke is discussed and the indications for PFO-closure, including the relevant related clinical trials, are reviewed. The available closure devices and the techniques utilized for percutaneous PFO-closure are also discussed.

Selected Topics in Post-Stroke Rehabilitation
(Angela Carbone or Whitney Pratt)

 

The lecture begins with a review of the functional rating systems, including the NIHSS and mRS, used in stroke research. A discussion of neuroplasticity and post-stroke rehabilitation principles and techniques follows. Finally, several topics related to post-stroke complications and rehabilitation are discussed, including the diagnosis and management of post-stroke depression, management of post-stroke headaches, and the management of spasticity.

Evidence-Based Medicine and Critical Appraisal of Stroke Literature
(Laurie Gutmann, MD)

This lecture will provide an overview of the principles of stroke research and clinical trial design. A discussion of the limitations and merits of selected trail designs is included. This is followed by a discussion of sources of bias in research trials. Finally, the models of stroke used in basic science research are discussed.

Neurocritical Care
(Shelly Timmons, MD)

Topics covered in this lecture include: management of increased ICP; airway management in the patient with increased ICP and critical neurological illness; and indications for hemicraniectomy after stroke.

Large Artery Disease and Atherosclerosis
(Ann Jones, MD)

 Discusses ischemic stroke related to large artery disease. Topics include management of extracranial carotid stenosis, extracranial vertebrobasilar stenosis, intracranial stenosis, and extracranial and intracranial dissections. Relevant clinical trials will be reviewed.

Cryptogenic Stroke: rare and unusual causes of stroke, stroke in the young
(James Fleck, MD)

 Selected topics for this lecture include hypercoagulable states, monogenic stroke syndromes, and vasculitis.

Intracranial Hemorrhage
(Jason Mackey, MD)

 Covers the epidemiology, pathology, presentation, diagnosis, and treatment of intracranial hemorrhage (including IPH, SDH, non-aneurysmal SAH, and CVST). Relevant clinical trials will also be reviewed.
 

Vascular Malformations (Bradley Bohnstedt, MD)

 Covers the epidemiology, pathology, presentation, diagnosis, and treatment of aneurysms, AVMs/dAVFs, and cavernous malformations 

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Resident Lecture Series

The vascular neurology fellow will have the opportunity to participate as a lecturer in the resident didactic series. During two 2-hour sessions, residents will provide education on the following vascular topics:

  • Vascular Neuroanatomy
  • Lacunar and Large Artery Stroke Syndromes
  • Unusual Causes of Stroke/Stroke in the Young
  • Early Management of Acute Ischemic Stroke