Stroke Program Education

U112 Stroke Service (approx. 1-week alternate month)

Unit 112 or acute stroke service entails being on call for acute/stat strokes during the day along with managing recently treated patients admitted to the service. Patients admitted to U112 include those receiving thrombolysis and/or endovascular treatment(EVT) for acute ischemic stroke, malignant ischemic stroke, post-carotid stenting/carotid endarterectomy and acute intracerebral hemorrhage. Fellows learn about acute stroke care e.g.: blood pressure management after thrombolysis/ EVT/ post carotid stenting/in acute ICH, management of complications post thrombolysis (like angioedema) or post EVT (like groin complications), monitoring of patients with malignant ischemic stroke or large intracerebral hemorrhage who may need surgical intervention.

U100 Stroke Unit Service (approx. 1-week alternate month)

Unit 100 service is a step down unit and gives opportunity to manage patients with subacute stroke and offers deeper understanding of stroke mechanisms along with secondary stroke prevention. It allows the fellow to be a part of multi-disciplinary team comprising of physiotherapist, occupational therapist, speech language pathologist, social worker and nurses to understand needs of rehabilitation and accordingly make decisions about patient disposal for those admitted during service. It also gives the fellow a chance to enroll patients in non-acute stroke trials.

On Call Stroke Fellow (approx. 4-5 per month)

The on-call stroke fellow starts call from 15:30 until 08:00 the next day during weekdays and 24-hour on weekends. It is perhaps the best window for fellows to get hands-on experience in decision making for acute strokes. Calls offer seeing a wide variety of patients including stroke mimics, acute and subacute strokes. All patients are discussed with attending stroke neurologist on call. During this time, fellow enhances his/her CTA reading skills and decision-making processes for acute stroke management. It also allows fellows to make decisions via tele-consults for patients in ER/ward units admitted in other hospitals within and outside Calgary. On-call shifts also lets fellows to enroll in various acute-window clinical trials.

Stroke Prevention Clinic/TIARA (TIA Rapid Assessment) clinic (approx. 4-5 per month)

The TIARA clinic allows fellows to see patients with recent transient neurologic event urgently and help in stratifying etiology of the event as well as deciding on further management.

In-patient Follow-up Clinic (approx. 1-2 per month)

The in-patient follow-up clinic allows fellows to follow-up on patients admitted at the time of their service at the end of 3-months. It gives immense sense of completeness as the fellow admits these patients acutely and the clinic gives them an option to see how these patients did, follow-up on their pending results and also build a relationship with them.

Rounds

• Tuesday afternoon journal club
• Wednesday afternoon fellow half-day
• Thursday morning weekly case rounds
• Thursday noon stroke academic lecture
• Friday morning Department of Clinical Neurosciences Grand Rounds

Stroke Electives:

• Transcranial Doppler Service (Vasospasm monitoring, Sickle cell disease, TCD Bubble Studies, TCD emboli detection, etc...)
• Neurocritical Care Service (with Neurocritical Care Neurology)
• Neurointerventional Service (with Interventional Neurologist)
• Stroke Rehabilitation Clinic (with Stroke Physical Medicine and Rehabilitation)
• Neurovascular Clinic (with Vascular Neurosurgery and Interventional Neuroradiology)
• Pediatric Stroke Clinic (with Pediatric Stroke Neurology)
• Neurovestibular Clinic (with Neuro-otologists)
• Neurocognitive Clinic