Sub-specialty training in Neuro-radiology
There is a fully accredited STR post in Neuro-radiology based at Frenchay Hospital. The scheme provides excellent sub-specialty training in all aspects of diagnostic and interventional neuro-radiology
The post is for two years, Years 5 and 6 of training. STRs are eligible to apply for the post to commence after they have completed 4 years of general radiology training, and having passed FRCR. They have to extend their training from 5 to 6 years, and obtain CCT at the end of their 6th year. Once they have taken this step, the CCT date can not be brought forward. The post is advertised nationally when it becomes vacant.
The post is based in the department of neuro-radiology at Frenchay Hospital, part of North Bristol NHS Trust. The neurosciences division provides tertiary referral services for patients with neurological disease for much of the South West of England, covering a population of nearly 3 million. The paediatric population covered by the neurosurgical department extends to the entire South West peninsula. The department also provides secondary services to the local population of North Bristol and South Gloucestershire.
The department has a 4-slice Siemens CT scanner, and a volumetric 64-slice Siemens CT scanner. In addition there are two 1.5 Tesla Philips MR scanners, one single plane Philips angiography suite and one dual plane GE angiography suite, where most of the interventional procedures are performed. There is also a dual headed Gamma camera for cerebral SPECT and DaT scans.
Neuro-radiology has close links with the departments of neurosurgery, neurology, neurophysiology, neuropathology, medicine, orthopaedics and accident and emergency. Experience can also be offered in head and neck radiology.
The working week revolves around the diagnostic workload and includes discussion with clinicians, arranging appropriate protocols, advising the radiographers as scans are performed and finally reporting the investigations. Aside from MRI, CT and plain film examinations, which comprise the bulk of the imaging, the diagnostic workload includes cerebral and spinal angiography, functional MRI, myelography, discography and radionuclide medicine. There is a very busy interventional service covering brain and spinal endovascular work. This includes coil embolisation of ruptured and unruptured cerebral aneurysms, sometimes with balloon or stent remodelling or parent vessel occlusion, embolisation of arteriovenous malformations and dural arteriovenous fistulae using Onyx, and preoperative embolisation for head and neck cancer and neurosurgical brain and spinal lesions. There are numerous spinal interventions performed including nerve root and facet joint blocks using both fluoroscopy and CT. Vertebroplasty and Kyphoplasty are also performed on a regular basis. The epilepsy surgery program requires WADA cerebral angiography to assess hemispheric dominance. There is also a busy functional neurosurgery program.
There are clinical meetings supporting a large range of services. These include a daily neurosurgical round to discuss the acute admissions, a joint neurovascular meeting to discuss the management of, amongst other things, complex aneurysms, arteriovenous malformations and dural fistulae. There are weekly paediatric neurology-neurosurgery and separate neonatal meetings. There are regular meetings to support the active epilepsy surgery program, a weekly clinical-pathological meeting where the preoperative radiology is reviewed; there are several meetings devoted to neurology, stroke, neurogenetics, and dementia and there are meetings with the spinal neurosurgical and orthopaedic surgeons. Finally there are separate meetings to discuss the head and neck cancers and other ENT work.
The neurosciences directorate has weekly educational meeting throughout the year and there are ample opportunities to attend appropriate courses and conferences.
There are many teaching opportunities. These include teaching radiographers, final year medical students, more junior radiology registrars and clinicians of all grades in other specialities such as neurology, neurosurgery, accident and emergency and medicine.
There is a 1:6 on call commitment on the consultant rota.
Consultants: All consultants are involved in general diagnostic neuro-radiology. Special interests are also listed below.
Dr N Stoodley Paediatrics, Genetics, Medicolegal
Dr M Likeman Paediatrics, Epilepsy, Functional
Dr S Renowden Endovascular Intervention
Dr A Molyneux Endovascular Intervention
Dr V Beric Spinal Intervention
Dr T Lewis Nuclear Medicine, Clinical Director
Prepared by Dr Marcus Bradley
Specialist Registrar in Neuro-radiology