Endovascular Neurosurgery (Interventional Neuroradiology)

Course Structure

1. Pathology of lesions amenable to interventional neuroradiological techniques. The natural history of such conditions and the indications for interventional measures. Anatomy of the central nervous system with special reference to vascular anatomy including common variations to the normal pattern. The embryology and phylogenology of the blood supply of the head and spine. Vascular physiology with special reference to the cerebral and spinal circulations. Normal and potential sites of collateral circulation. Endovascular routes to lesion of the head and spine.
2. Radiological techniques and other imaging techniques for localisation and evaluation of cerebral and spinal lesion, including angiography, myelography, CT and MR scanning, doppler ultra sound (transcranial and intra-operative) and the use of radiopharmaceuticals. Electrophysiological and cerebral blood flow measurement techniques as well as cardiovascular monitoring pertinent to interventional neuroradiological procedures.
3. Critiques of research papers (done as part of data handling), attendance at tutorial groups, personal development, statistics and IT methods will be included over the first two terms. Each student will be assigned to a tutor for the duration of the Diploma or MSc.
4. Interventional techniques for biopsy, embolisation, thrombolysis and angioplasty. Delivery systems: their construction and applications. Embolisation materials including balloons, coils, stents, particulate and liquid embolic agents and their advantages and disadvantages for different applications. Pre- and post-procedural precautions, including indications for treatment, informed consent, and the recognition and management of complications.
5. The official names, constitutional pharmacology, modes of administration, clinical uses, routes of administration, relative advantages and side effects of drugs and other agents used in interventional neuroradiological techniques. Sedation and the provision of analgesia during procedures. Use of anticoagulation, fibrinolytic and anti convulsant agents.