Neurology

Neurological diagnostic skills and a complete understanding of medical neurology are essential to an optimal neurosurgical practice. Each resident spends 3 months on the adult neurology service at HUH and DRH. Electively, the resident may do a rotation at CHM on the pediatric service. The neurology rotation includes experience with neurology consults and inpatient services, including general neurology, epilepsy, stroke, and movement disorders, the clinical electrophysiology lab and the critical care neurotrauma unit. The resident performs clinical evaluations, orders diagnostic tests, follows the in-house patients and consults, and attends neurology conferences. The neurology elective includes neurological critical care and patient management for non-operative and post-operative neurotrauma at DRH. The resident is expected to present one lecture from this experience during Grand Rounds. The resident is supervised by the neurology faculty.

Neuropathology

Neuropathology provides vital diagnostic information after neurosurgical procedures for neoplasm or degenerative disease. A solid foundation in neuropathology is essential for a complete understanding of neurosurgical disease entities. Each resident spends 3 months in neuropathology under the direct supervision of the director of neuropathology. The resident leans the basic principles of gross and microscopic neuropathology, including the methods and rationale for special stains, how to evaluate frozen and permanent sections of surgical specimens, and how to evaluate immunohistochemical stains and electron microscopy. Participation in examination of autopsy specimens at brain cutting and microscopy sign-out includes review of gross and microscopic neuroanatomy in addition to instruction in medical neuropathology. The resident is expected to attain proficiency in identifying common neoplasms. The resident is expected to present neuropathological material at CPC and tumor conferences.

Neuroanatomy

The resident is trained in neuroanatomy throughout the residency. Many of the didactic sessions are devoted to neuroanatomy, including study of autopsy material, skull specimens, spine specimens and selected microscopic material. The faculty emphasizes neuroanatomy during surgical cases and teaching rounds. Residents also participate in cadaver courses and in the Motor Skills Lab. Further, during the lab research year, the resident is instructed in neuroanatomy by the PhD faculty.

Neurophysiology

Training in neurophysiology for the neurosurgery residents occurs during didactic sessions and during the one year of lab research. The faculty emphasizes the neurophysiology correlates of clinical conditions encountered on the service. Evoked potential monitoring routinely performed during many craniotomies and intraspinal cases, provides relevant teaching for residents also. The resident in the lab also attends the Research Update in Neuroscience for Neurosurgeons (RUNN) course at Woods Hole in Cape Cod which is a week of intensive neurophysiology courses.

Neuroradiology

A substantial level of competence in interpreting neuroradiological studies is essential to neurosurgical diagnosis, as well as, planning of neurosurgical procedures. In addition, endovascular techniques have become an important adjunct to treatment of many neurosurgical diseases. The resident spends 3 months on the neuroradiology rotation where he or she takes an active role in evaluation of diagnostic MRI, CT scanning and angiography. The resident participates in all cerebral angiography, including diagnostic and interventional cases. The resident assists with endovascular procedures including aneurysm coiling, AVM embolization, and treatment of vasospasm. The resident performs under the supervision of the faculty radiologists and neuro-interventional faculty. The resident further receives neuroradiology training during all clinical rotations during didactic sessions and during teaching rounds. The resident is expected to present two neuroradiology lectures during this rotation during conferences.