Neurocritical Care and Cerebrovascular
Curriculum

Curriculum

The Neurocritical Care and Cerebrovascular Fellowship’s goal is to prepare physicians to practice independently and provide expert clinical care in common and uncommon disorders affecting the nervous system and to engage in scholarship through supervised training in the following areas:

  • Diagnosis and management of neurologic emergencies and complications of systemic disease to include refractory status epilepticus and epilepsy exacerbations, neuromuscular disorders, autoinflammatory and infectious CNS disease, cerebrovascular disease, encephalopathy in the hospitalized patient, evaluation of end-stage multiorgan dysfunction and other relevant disorder
  • Emergent support of ischemic stroke through identification and treatment selection for thrombolytic and endovascular procedures for pediatric patients
  • Technical expertise in the bedside use of neurologic diagnostics including continuous EEG monitoring and neuroimaging with exposure to prognostic and diagnostic electrophysiology tools
  • Presentation and discussion of complex cerebrovascular disorders including treatment selection in consultation with endovascular, neurosurgical, and radiation oncology surgical providers
  • Comprehensive examination technique in the hospitalized and encephalopathic child
  • Administrative, management, and economic aspects of neurocritical care service structure
  • Exposure to telehealth consultation to local satellite hospitals

This fellowship is unique due to the broad curriculum in both neurocritical care and cerebrovascular medicine.

Neurocritical Care

Cincinnati Children's has three faculty who specialize in neurocritical care, each with subspecialty clinical and research interests. The group services the hospital inpatient consult service for 44 weeks annually, providing decision support to faculty and residents throughout the year. Our consistent presence on the critical care units have made neurology an indispensable service for the hospital. We employ evidence-based care and continuously refine care algorithms to ensure state-of-the-science care for our patients. In this way, the same faculty who meet families in the trauma bay remain a vital part of the care team in the recovery clinic. Fellows immediately become leaders of the care team that families rely upon to guide their child’s recovery.

Cerebrovascular Medicine

The Cerebrovascular Center provides multidisciplinary care to children and young adults with stroke and vascular anomalies. Faculty bring specialty expertise from neurology, neurosurgery, interventional radiology, hematology, genetics, psychology, rehabilitation, neuroradiology, and radiation oncology together to deliver better care to children. This team of clinician scientists are active researchers studying the biology, developmental pathology, behavioral outcomes and cutting-edge imaging techniques in pediatric vascular disease. We are leaders in education, hosting CME events multiple times yearly locally and nationally. Fellows are introduced to the team their first month at Cincinnati Children's and then participate in acute management, conferences, CME, and clinical duties throughout the year.

Fellows are given considerable latitude to build a clinical curriculum which meets their professional needs. The ultimate goal for our program is to train physicians for independent practice in the fields of pediatric neurocritical care and / or vascular neurology with a specialized interest of their choosing. Below is a sample rotation schedule for reference.

  • Pediatric Neurocritical Care Consults – 24 weeks. Fellow supervises care for a team of neurology residents in the direct care of children in the pediatric and cardiac critical care units.
  • Adult Neurocritical Care Unit – 4 weeks. Clinical service as the front-line provider in the busy adult Neurocritical Care and Stroke Unit at University of Cincinnati Hospital.
  • Clinical Neurophysiology – 4 weeks. EEG and long-term monitoring training with Cincinnati Children's epilepsy faculty.
  • Neuroradiology – 4 weeks. Imaging review with attention to early identification of acute neurologic emergencies.
  • Pediatric Neurosurgery / Endovascular Neurosurgery – 4 weeks. Rotation with our faculty neurosurgeons in the OR and IR suites facilitating the vital partnership with surgical colleagues and exposing technical aspects of acute neurologic stabilization.
  • Pediatric Rehabilitation – 4 weeks. Inpatient management of patients recovering in main campus rehabilitation ward.
  • Intraoperative monitoring – 2 weeks. Rotation with faculty at Cincinnati Children's and the University of Cincinnati during operative monitoring of complex cranial and spinal surgical procedures.
  • Cardiac Intensive Care Unit – 2 weeks. Direct management of complex cardiac physiology and exposure to ECMO and VAD support.
  • Longitudinal Experiences
    • Cerebrovascular Consults – decision support for resident staff on emergent vascular cases.
    • Brain Injury Clinic – patient follow-up in multidisciplinary recovery clinic.
    • Cerebrovascular Center – outpatient management of vascular cases in the CV and stroke clinics.
  • Call is taken from home during Pediatric Neurocritical Care Consult rotations and consists of supervision of the child neurology residents responding to acute neurologic emergencies. Attending backup is available at all times.
  • Vacation – 4 weeks. Typically taken in 1-2 week blocks. Time is allotted during rotations to facilitate travel for interviews / recruitment.
  • Neurocritical Care Team Conference (weekly) – case discussion, research meeting, journal club, administrative meeting
  • Brain Injury Clinic Team Meeting (weekly)
  • Cerebrovascular Huddle (weekly)
  • Cerebrovascular Conference (monthly)
  • Cerebrovascular Research Meeting (monthly)
  • Pediatric Neurology Didactics
    • Mind, Brain, Behavior Grand Rounds (weekly)
    • Neuroradiology Conference (weekly)
    • Not Just Neurology (weekly)
    • Pharmacology Lecture Series (weekly)
    • Morbidity and Mortality Conference (monthly)
  • Critical Care Medicine Didactics (weekly)
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